Organization Active NPI

La Jolla Orthopaedic Surgery

  • Neurological Surgery Physician
  • San Diego, CA
National Provider Identifier
1952330037
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LA JOLLA ORTHOPAEDIC SURGERY
Practice address
4510 Executive Dr
S125
San Diego, CA 92121-3021
Phone
(858) 643-5650
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Howard Tung, M.D.
Title
Chief, la Jolla Orthopaedic Surgery
Phone
(858) 643-5650

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X CA Primary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X CA

Addresses

Primary practice location

4510 Executive Dr
S125
San Diego, CA 92121-3021

Mailing address

4510 Executive Dr
S125
San Diego, CA 92121-3021
Phone (858) 643-5650

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ00696ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

9900 Genesee Ave
Ste C
La Jolla, CA 92037
Phone (858) 453-8060

4510 Executive Dr
#S125
San Diego, CA 92121
Phone (858) 643-5650

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": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1952330037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR",
            "address_2": "S125",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213021",
            "telephone_number": "858-643-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR",
            "address_2": "S125",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213021",
            "telephone_number": "858-643-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA ORTHOPAEDIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TUNG",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "CHIEF, LA JOLLA ORTHOPAEDIC SURGERY",
        "authorized_official_telephone_number": "858-643-5650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ00696Z",
            "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 Jul 21, 2022; 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.