Organization
SAN DIEGO PREMIER SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY CHONG MD (CHIEF MEDICAL OFFICER)
(818) 855-1507
Entity
Organization
Contact information
Practice address
3434 MIDWAY DR STE 1008, SAN DIEGO, CA 92110-4924
(818) 855-1507
Mailing address
425 15TH ST UNIT 3195, MANHATTAN BEACH, CA 90266-7316
(818) 855-1507
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
01/15/2025
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