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General NPI Number Information
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NPI Number | 1336484096
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Entity Type | Organization
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Legal Business Name | HIGHLY ARTISTIC SURGERY, INC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 15725 POMERADO RD STE 212 HIGHLY ARTISTIC SURGERY, INC
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City | POWAY
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State | CA
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Zip | 92064-2060
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Country | US
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Telephone | 858-487-3742
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Fax | 858-206-3742
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Provider Business Mailing Address
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Address Line | 15725 POMERADO RD STE 212 HIGHLY ARTISTIC SURGERY, INC
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City | POWAY
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State | CA
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Zip | 92064-2060
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Country | US
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Telephone | 858-487-3742
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Fax | 858-206-3742
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Authorized Official
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Title or Position | CHAIR
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Name | DR. CHI D HA
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Credential | M.D., FACS
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Telephone | 858-487-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A105747
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License Number State | CA
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