San Diego Sports Medicine & Orthopaedic Center Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SAN DIEGO SPORTS MEDICINE & ORTHOPAEDIC CENTER INC.

Practice address

6719 Alvarado Rd Ste 200
San Diego, CA 92120-5256

Phone

(619) 229-3932

Fax

(619) 582-2860

NPI assigned

Aug 31, 2017

Organization subpart

No

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

Authorized official

Name

Miss Lisa Marie Sullivan

Title

Administrator

Phone

(619) 229-3932

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1356869119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205256",
            "telephone_number": "619-229-3932",
            "fax_number": "619-582-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205256",
            "telephone_number": "619-229-3932",
            "fax_number": "619-582-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO SPORTS MEDICINE & ORTHOPAEDIC CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-229-3932",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• San Diego Sports Medicine & Orthopaedic Center
• San Diego Sports Physical Therapy, PC
• San Diego State University
• San Diego State University
• San Diego State University - Healthy Early Years Clinic
• San Diego State University Center for Autism and Developmental Disorders

• Orthopaedic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.