Organization
INLAND VALLEY SURGICAL CENTER
Active
Other names
Nissanoff Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN NISSANOFF MD (CEO/OWNER)
(858) 451-2280
Entity
Organization
Contact information
Practice address
15525 POMERADO RD., SUITE E6, POWAY, CA 92064
(858) 451-2280
(858) 451-2006
Mailing address
PO BOX 502530, SAN DIEGO, CA 92150-2530
(858) 451-2280
(858) 451-2006
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23424
AAAHC
CA
Enumeration date
07/30/2006
Last updated
07/24/2008
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