Healthcare Provider Details

I. General information

NPI: 1497687057
Provider Name (Legal Business Name): DIAMOND SURGICAL SUITES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 LA MESA BLVD STE 100
LA MESA CA
91942-9216
US

IV. Provider business mailing address

8200 LA MESA BLVD STE 100
LA MESA CA
91942-9216
US

V. Phone/Fax

Practice location:
  • Phone: 619-657-4559
  • Fax:
Mailing address:
  • Phone:
  • 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: CHARLESTON CHUA
Title or Position: PRESIDENT
Credential: MD
Phone: 619-657-4559