Elite Specialty Surgery Center of Chula Vista, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

ELITE SPECIALTY SURGERY CENTER OF CHULA VISTA, LLC

Practice address

256 Landis Ave
Chula Vista, CA 91910-2650

Phone

(619) 616-7641

NPI assigned

Sep 18, 2024

Organization subpart

No

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

Authorized official

Name

Alexander Salloum, MDNPI 1124176151

Title

Ceo

Phone

(619) 616-7641

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander Charles Salloum, MD

  • Vascular Surgery Physician
  • Chula Vista, CA
  • NPI 1124176151
  NPD Authorized official

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1467289884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 E PENNSYLVANIA AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254616",
            "telephone_number": "760-884-4500",
            "fax_number": "619-567-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 LANDIS AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102650",
            "telephone_number": "619-616-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPECIALTY SURGERY CENTER OF CHULA VISTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "SALLOUM",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-616-7641",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.