Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Corey Ian Ambrose

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1669058251

Corey Ian Ambrose is a General Surgery in Los Angeles, California. Graduated from University of Washington School of Medicine in 2021, 5 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
5
Trained at
University of Washington School of Medicine
In the registry since
2021
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Practice location Address checks out

1200 N State St Ste A7D
Los Angeles, CA 90089-1001
Phone: (323) 409-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1669058251
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 23, 2021
Last updated in NPPESOctober 15, 2024
Certification dateMarch 23, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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