Active NPI
Ambulatory Care Surgery Center
- Ambulatory Surgical Clinic/Center
- San Diego, CA
National Provider Identifier
1639118029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 080000458
- Legal business name
- AMBULATORY CARE SURGERY CENTER
- Practice address
- 5225 Kearny Villa Way
San Diego, CA 92123-1410 - Phone
- (858) 974-7200
- Fax
- (858) 974-7245
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Caroline Baddour
- Title
- Ceo
- Phone
- (858) 974-7200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 080000458 | CA | Primary |
Addresses
Primary practice location
5225 Kearny Villa Way
San Diego, CA 92123-1410
Mailing address
5225 Kearny Villa Way
San Diego, CA 92123-1410
Phone (858) 974-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080000458 | Other | CA | STATE OF CALIFORNIA LICEN |
National Provider Directory
National Provider DirectoryLocations
5225 Kearny Villa Rd
San Diego, CA 92123
Phone (848) 974-7200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1287360000000",
"number": "1639118029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5225 KEARNY VILLA WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231410",
"telephone_number": "858-974-7200",
"fax_number": "858-974-7245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 KEARNY VILLA WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231410",
"telephone_number": "858-974-7200",
"fax_number": "858-974-7245"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMBULATORY CARE SURGERY CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2010-10-18",
"status": "A",
"authorized_official_last_name": "BADDOUR",
"authorized_official_first_name": "CAROLINE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "858-974-7200"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "CA",
"license": "080000458",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA LICEN",
"identifier": "080000458",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.