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Individual

DR. AMBAR MATTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2945 S DOBSON RD, MESA, AZ 85202-7941
(480) 969-4138
(480) 969-0630
Mailing address
2320 N 3RD ST, PHOENIX, AZ 85004-1303
(602) 258-9900
(602) 258-9904

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101258628
VA
208600000X
Surgery Physician
57.015725
OH
208600000X
Surgery Physician
Primary
58734
AZ

Other

Enumeration date
06/14/2011
Last updated
07/25/2022
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