Organization
LA JOLLA ORTHOPAEDIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD TUNG M.D. (CHIEF, LA JOLLA ORTHOPAEDIC SURGERY)
(858) 643-5650
Entity
Organization
Contact information
Practice address
4510 EXECUTIVE DR, S125, SAN DIEGO, CA 92121-3021
(858) 643-5650
Mailing address
4510 EXECUTIVE DR, S125, SAN DIEGO, CA 92121-3021
(858) 643-5650
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
CA
207Y00000X
Otolaryngology Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ00696Z
BLUE SHIELD
CA
Enumeration date
07/01/2006
Last updated
07/21/2022
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