NPIMap

Organization Active NPI

Heart of San Diego Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
National Provider Identifier
1639815129
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HEART OF SAN DIEGO SURGICAL CENTER LLC
Practice address
8705 Complex Dr Ste 202
San Diego, CA 92123-1401
Phone
(858) 302-2502
NPI assigned
May 9, 2022
Last updated
Jul 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Dr. Mehran Moussavian, DONPI 1689788234
Title
Ceo
Phone
(619) 518-5345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

8705 Complex Dr Ste 202
San Diego, CA 92123-1401

Mailing address

8787 Complex Dr Ste 202
San Diego, CA 92123-1451
Phone (619) 807-1981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230810003479 CA Part B Supplier - Ambulatory Surgical Center 1951763770 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

8705 Complex Dr
Ste 202
San Diego, CA 92123
Phone (858) 302-2502

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1639815129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 COMPLEX DR STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231451",
            "telephone_number": "619-807-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 COMPLEX DR STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231401",
            "telephone_number": "858-302-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF SAN DIEGO SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "MOUSSAVIAN",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-518-5345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.