Healthcare Provider Details

I. General information

NPI: 1851223416
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
LA MESA CA
91942-9216
US

IV. Provider business mailing address

8200 LA MESA BLVD
LA MESA CA
91942-9216
US

V. Phone/Fax

Practice location:
  • Phone: 858-699-0707
  • Fax: 725-215-9015
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: OWNER
Credential: MD
Phone: 702-460-6009