# EASTLAKE SURGERY CENTER

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

## Provider details

- **NPI number:** 1457535395
- **Authorized official:** NOJAN TALEBZADEH M.D.,D.M.D, J.D. (OWNER)
- **Authorized official phone:** (619) 216-8000

## Contact information

- **Practice address:** 890 EASTLAKE PKWY, SUITE \#100, CHULA VISTA, CA 91914-4520
- **Practice address phone:** (619) 216-8000
- **Practice address fax:** (619) 216-3223
- **Mailing address:** 890 EASTLAKE PKWY, SUITE \#100, CHULA VISTA, CA 91914-4520
- **Mailing address phone:** (619) 216-8000
- **Mailing address fax:** (619) 216-3223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A064127 | CA | Yes |

## Other

- **Enumeration date:** 12/27/2007
- **Last updated:** 12/27/2007