Organization Active NPI

San Diego Sports and Minimally Invasive Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
National Provider Identifier
1801045430
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SAN DIEGO SPORTS AND MINIMALLY INVASIVE SURGERY CENTER LLC
Practice address
3939 Ruffin Rd
Suite 100
San Diego, CA 92123-1815
Phone
(858) 449-4071
NPI assigned
Sep 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Mr. Marc D Jang
Title
President & Ceo
Phone
(916) 614-3608

Specialties & licenses 1

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

Addresses

Primary practice location

3939 Ruffin Rd
Suite 100
San Diego, CA 92123-1815

Mailing address

3939 Ruffin Rd
Suite 100
San Diego, CA 92123-1815

Other names 1

  • SMI Surgery Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1801045430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 RUFFIN RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 RUFFIN RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231815",
            "telephone_number": "858-449-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO SPORTS AND MINIMALLY INVASIVE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "JANG",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "916-614-3608",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMI Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 18, 2008; 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.