Organization
INNOVATIVE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHANG THAI NGUYEN MD (PRESIDENT)
(858) 457-2888
Entity
Organization
Contact information
Practice address
6610 FLANDERS DR, SUITE 100, SAN DIEGO, CA 92121-3940
(858) 457-2888
Mailing address
6610 FLANDERS DR, SUITE 100, SAN DIEGO, CA 92121-3940
(858) 457-2888
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
A90876
CA
Other
Enumeration date
05/23/2014
Last updated
07/21/2015
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