Organization
LA JOLLA ORTHOPAEDIC SURGERY
Active
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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