Provider Demographics
NPI:1447444732
Name:POHL, AMBER MICHELLE (PA-C)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:MICHELLE
Last Name:POHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2100 POWELL ST.
Mailing Address - Street 2:SUITE 920
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1803
Mailing Address - Country:US
Mailing Address - Phone:510-350-2777
Mailing Address - Fax:954-597-7773
Practice Address - Street 1:2100 POWELL ST.
Practice Address - Street 2:SUITE 920
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1803
Practice Address - Country:US
Practice Address - Phone:510-350-2777
Practice Address - Fax:954-597-7773
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
CAPA22013363AM0700X
FLPA9104342363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical