Organization
LA JOLLA SPINE INSTITUTE MEDICAL GROUP, INC.
Active
Organization
LA JOLLA SPINE INSTITUTE MEDICAL GROUP, INC.
Active
Other names
Spine Institute of San Diego
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMIN RAISZADEH MD (PRESIDENT)
(619) 265-7912
Entity
Organization
Contact information
Practice address
6719 ALVARADO RD., SUITE 308, SAN DIEGO, CA 92120
(619) 265-7912
(619) 265-7922
Mailing address
6719 ALVARADO ROAD, SUITE 308, SAN DIEGO, CA 92120
(619) 265-7912
(619) 265-7922
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A111653
MEDICAL BOARD OF CA
CA
01
—
A88341
LICENSE NUMBER
CA
Enumeration date
12/19/2006
Last updated
02/09/2023
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