# SAN DIEGO UROLOGY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316713332
- **Authorized official:** ROSEANN GONZALEZ (ADMINISTRATOR)
- **Authorized official phone:** (714) 856-5472

## Contact information

- **Practice address:** 12650 SABRE SPRINGS PKWY STE 204, SAN DIEGO, CA 92128-4114
- **Practice address phone:** (714) 856-5472
- **Mailing address:** 23052 ALICIA PKWY STE 619, MISSION VIEJO, CA 92692-1643
- **Mailing address phone:** (714) 856-5472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2023
- **Last updated:** 11/30/2023