Organization
LA JOLLA SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN PORTER (OFFICE MANAGER)
(858) 453-7224
Entity
Organization
Contact information
Practice address
4510 EXECUTIVE DR STE 200A, SAN DIEGO, CA 92121-3023
(858) 453-7224
Mailing address
4510 EXECUTIVE DR STE 200A, SAN DIEGO, CA 92121-3023
(858) 453-7224
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
B2005004775
CA
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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