New Vision Office Surgery LLC
Clinic/Center, Ambulatory Surgical in La Jolla, CA. Organization (NPI-2).
NPI number1508551946
StatusActive
Last updated in NPPESOct 13, 2023
Details
- NPI
- 1508551946
- Entity type
- Organization (NPI-2)
- Legal business name
- New Vision Office Surgery LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2023
- Certification date
- Oct 13, 2023
- Last updated
- Oct 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | – | – | Yes |
| 261QS0132X | Clinic/Center, Ophthalmologic Surgery | – | – |
Practice location
4130 La Jolla Village Dr Ste 300La Jolla, CA 92037-1481
Phone 858-455-6800
Mailing address
4130 La Jolla Village Dr Ste 300La Jolla, CA 92037-1481
Phone 858-455-6800
Authorized official
Michael Gordon
Medical Director
8584556800
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