Healthcare Provider Details

I. General information

NPI: 1740409721
Provider Name (Legal Business Name): TORREY HILLS SURGICAL SPECIALTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 CARMEL MOUNTAIN RD STE 105
SAN DIEGO CA
92130-6657
US

IV. Provider business mailing address

4765 CARMEL MOUNTAIN RD STE 105
SAN DIEGO CA
92130-6657
US

V. Phone/Fax

Practice location:
  • Phone: 858-481-8248
  • Fax: 858-481-8612
Mailing address:
  • Phone: 858-481-8248
  • Fax: 858-481-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberA94751
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4631
License Number StateCA

VIII. Authorized Official

Name: DR. NOUSHIN SHOAEE
Title or Position: CFO
Credential: DPM
Phone: 858-481-8240