# LA JOLLA SURGERY CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1538463153
- **Authorized official:** ROBIN PORTER (OFFICE MANAGER)
- **Authorized official phone:** (858) 453-7224

## Contact information

- **Practice address:** 4510 EXECUTIVE DR STE 200A, SAN DIEGO, CA 92121-3023
- **Practice address phone:** (858) 453-7224
- **Mailing address:** 4510 EXECUTIVE DR STE 200A, SAN DIEGO, CA 92121-3023
- **Mailing address phone:** (858) 453-7224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | B2005004775 | CA | Yes |

## Other

- **Enumeration date:** 12/23/2010
- **Last updated:** 12/23/2010