LA JOLLA SURGERY CENTER
Ambulatory Health at Executive Dr, San Diego, CA

License number
California B2005004775
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: ROBIN PORTER
Title: OFFICE MANAGER
Phone: (858) 453-7224
Address
Address
4510 Executive Dr STE 200A, San Diego, CA 92121
National Provider ID: 1538463153
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LA JOLLA SURGERY CENTER, INC

San Diego, CA

Registration:
Feb 18, 2005
Addresses:
4510 Executive Dr #200, San Diego, CA 92121 (Physical)
8899 University Ctr Ln, San Diego, CA 92122
State ID:
C2733879
Business type:
Articles of Incorporation
President:
Steven R. Cohen (President)
Agent:
Steven R Cohen,San Diego, CA 92121 (Physical)

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