Healthcare Provider Details
I. General information
NPI: 1689521015
Provider Name (Legal Business Name): ABILITY BB SAN DIEGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10175 RANCHO CARMEL DR STE 124
SAN DIEGO CA
92128-3675
US
IV. Provider business mailing address
10175 RANCHO CARMEL DR STE 124
SAN DIEGO CA
92128-3675
US
V. Phone/Fax
- Phone: 858-324-5545
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 202D00000X |
| Taxonomy | Integrative Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRIS
MABRY
Title or Position: SOLE MEMBER
Credential: DC
Phone: 419-543-6767