Eastlake Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A064127 Issued in CA

Legal business name

EASTLAKE SURGERY CENTER

Practice address

890 Eastlake Pkwy
Suite #100
Chula Vista, CA 91914-4520

Phone

(619) 216-8000

Fax

(619) 216-3223

NPI assigned

Dec 27, 2007

Organization subpart

No

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

Authorized official

Name

Nojan Talebzadeh, M.D.,D.M.D, J.D.

Title

Owner

Phone

(619) 216-8000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1457535395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PKWY",
            "address_2": "SUITE #100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144520",
            "telephone_number": "619-216-8000",
            "fax_number": "619-216-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PKWY",
            "address_2": "SUITE #100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144520",
            "telephone_number": "619-216-8000",
            "fax_number": "619-216-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAKE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "TALEBZADEH",
        "authorized_official_first_name": "NOJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-216-8000",
        "authorized_official_credential": "M.D.,D.M.D, J.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "A064127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Lake Medical, LLC
• Eastlake Family Medical Inc.
• Eastlake Laser Eye Associates
• Eastlake Optometry Inc.
• Eastlake Sleep Center
• Eastlake Urgent Care a Professional Medical Corporation
• Eastlake Urgent Care LLC
• Michael Eaton, PT
• Myra Kurtz Ebeling, RD
• Krista Madison Eberle, PA

• Ambulatory Surgical Clinic/Center in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.