Healthcare Provider Details

I. General information

NPI: 1639091846
Provider Name (Legal Business Name): CITADEL SURGICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 3RD AVE STE 204
SAN DIEGO CA
92103-2130
US

IV. Provider business mailing address

4033 3RD AVE STE 204
SAN DIEGO CA
92103-2130
US

V. Phone/Fax

Practice location:
  • Phone: 858-395-6565
  • Fax: 619-295-7935
Mailing address:
  • Phone: 858-395-6565
  • Fax: 619-295-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRET JAMES LANGENBERG
Title or Position: SURGEON/OWNER
Credential: DO
Phone: 858-395-6565