# AMBACH MA, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bioevolve San Diego Orthobiologics and Sports Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194570259
- **Authorized official:** MARY AMBACH MD (OWNER)
- **Authorized official phone:** (239) 410-8441

## Contact information

- **Practice address:** 285 N EL CAMINO REAL STE 110, ENCINITAS, CA 92024-5384
- **Practice address phone:** (858) 225-1922
- **Practice address fax:** (858) 327-9656
- **Mailing address:** 285 N EL CAMINO REAL STE 110, ENCINITAS, CA 92024-5384
- **Mailing address phone:** (858) 225-1922
- **Mailing address fax:** (858) 327-9656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/22/2024
- **Last updated:** 11/12/2024