Organization Active NPI

Ambulatory Care Surgery Center

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
National Provider Identifier
1639118029
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
080000458 Issued in CA
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

Updated by the provider on Oct 18, 2010

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
080000458OtherCASTATE OF CALIFORNIA LICEN

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.