Individual
AMBARISH MUKUND ATHAVALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-7326
(858) 249-6748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-127463
IL
207RN0300X
Nephrology Physician
Primary
036-127463
IL
Other
Enumeration date
08/30/2010
Last updated
05/03/2024
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