San Diego Gastroenterology LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

A84519 Issued in CA

Legal business name

SAN DIEGO GASTROENTEROLOGY LLC

Practice address

3434 Midway Dr
Suite 1008
San Diego, CA 92110-4923

Phone

(310) 273-8885

NPI assigned

Feb 21, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ara Salazar

Title

Administrator, B&C

Phone

(310) 273-8885

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1346547767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 S FAIRFAX AVE",
            "address_2": "#379",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363124",
            "telephone_number": "310-273-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR",
            "address_2": "SUITE 1008",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104923",
            "telephone_number": "310-273-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO GASTROENTEROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "ARA",
        "authorized_official_title_or_position": "ADMINISTRATOR, B&C",
        "authorized_official_telephone_number": "310-273-8885"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A84519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.