Spine Institute of San Diego, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SPINE INSTITUTE OF SAN DIEGO, INC

Practice address

6719 Alvarado Rd
Suite 308
San Diego, CA 92120-5270

Phone

(619) 229-5340

Fax

(619) 229-7922

NPI assigned

Feb 16, 2009

Organization subpart

No

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

Authorized official

Name

Ramin Raiszadeh, M.D.

Title

President

Phone

(619) 265-7912

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1851530711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD",
            "address_2": "SUITE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205270",
            "telephone_number": "619-229-5340",
            "fax_number": "619-229-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD",
            "address_2": "SUITE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205270",
            "telephone_number": "619-229-5340",
            "fax_number": "619-229-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE INSTITUTE OF SAN DIEGO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-16",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "RAISZADEH",
        "authorized_official_first_name": "RAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-265-7912",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.