Organization Active NPI

Surgery Center of San Diego, LLC

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
National Provider Identifier
1902438112
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGERY CENTER OF SAN DIEGO, LLC
Practice address
3434 Midway Dr Ste 1008
San Diego, CA 92110-4924
Phone
(858) 432-7899
Fax
(858) 432-7868
NPI assigned
Feb 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Dr. Clayton A Varga, MDNPI 1629060694
Title
Manager
Phone
(626) 696-1400

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 Primary

Addresses

Primary practice location

3434 Midway Dr Ste 1008
San Diego, CA 92110-4924

Mailing address

10565 Civic Center Dr Ste 250
Rancho Cucamonga, CA 91730-3854
Phone (858) 432-7899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200406002078 CA Part B Supplier - Ambulatory Surgical Center 8224467683 Practice locations: San Diego, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center of San DiegoCCN 05C0002250
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

224 N Fair Oaks Ave
Ste 300
Pasadena, CA 91103
Phone (626) 696-1451

224 N Fair Oaks Ave
#3
Pasadena, CA 91103

3434 Midway Dr
Ste 1008
San Diego, CA 92110
Phone (858) 432-7899

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": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1902438112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10565 CIVIC CENTER DR STE 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303854",
            "telephone_number": "858-432-7899",
            "fax_number": "858-432-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR STE 1008",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104924",
            "telephone_number": "858-432-7899",
            "fax_number": "858-432-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF SAN DIEGO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "VARGA",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "626-696-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "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 Mar 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.