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General NPI Number Information
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NPI Number | 1407592983
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Entity Type | Organization
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Legal Business Name | HEART OF SAN DIEGO LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 8705 COMPLEX DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-1401
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Country | US
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Telephone | 858-302-2504
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Fax |
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Provider Business Mailing Address
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Address Line | 8787 COMPLEX DR STE 430
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City | SAN DIEGO
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State | CA
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Zip | 92123-1453
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Country | US
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Telephone | 858-302-2504
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | LINDA SALLEE
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Credential |
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Telephone | 858-302-2502
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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 |
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License Number State |
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