Healthcare Provider Details

I. General information

NPI: 1184143711
Provider Name (Legal Business Name): CENTER FOR AMBULATORY SURGICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 ALVARADO RD STE 100
LA MESA CA
91942-8901
US

IV. Provider business mailing address

7051 ALVARADO RD STE 100
LA MESA CA
91942-8901
US

V. Phone/Fax

Practice location:
  • Phone: 619-483-3451
  • Fax:
Mailing address:
  • Phone: 619-483-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT LAJVARDI
Title or Position: OWNER
Credential: MD
Phone: 619-483-3451