Healthcare Provider Details

I. General information

NPI: 1487807442
Provider Name (Legal Business Name): TORREY PINES SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 11/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE STE. 300
LA JOLLA CA
92037-1224
US

IV. Provider business mailing address

11999 SAN VICENTE BLVD STE 440
LOS ANGELES CA
90049-5042
US

V. Phone/Fax

Practice location:
  • Phone: 858-587-9850
  • Fax:
Mailing address:
  • Phone: 310-471-5852
  • Fax: 310-472-9582

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: JOHN SMOOT
Title or Position: OWNER
Credential: M.D.
Phone: 858-622-2066