Healthcare Provider Details

I. General information

NPI: 1598671232
Provider Name (Legal Business Name): AUSTIN B AMBUR DO FAAD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 CAMINO DEL RIO S STE 320
SAN DIEGO CA
92108-3850
US

IV. Provider business mailing address

2801 CAMINO DEL RIO S STE 320
SAN DIEGO CA
92108-3850
US

V. Phone/Fax

Practice location:
  • Phone: 619-240-8198
  • Fax: 619-483-3435
Mailing address:
  • Phone: 619-240-8198
  • Fax: 619-483-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN B AMBUR
Title or Position: PHYSICIAN OWNER
Credential: DO
Phone: 619-240-8198