| Innovative Surgery Center Llc | |
|
6610 Flanders Dr Suite 100 San Diego CA 92121-3940 | |
| (858) 457-2888 | |
| Not Available |
| Full Name | Innovative Surgery Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6610 Flanders Dr, San Diego, California |
| Authorized Official Name and Position | Khang Thai Nguyen (PRESIDENT) |
| Authorized Official Contact | 8584572888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Surgery Center Llc 6610 Flanders Dr Suite 100 San Diego CA 92121-3940 Ph: (858) 457-2888 | Innovative Surgery Center Llc 6610 Flanders Dr Suite 100 San Diego CA 92121-3940 Ph: (858) 457-2888 |
| NPI Number | 1740692730 |
|---|---|
| Provider Enumeration Date | 05/23/2014 |
| Last Update Date | 07/21/2015 |
| Medicare PECOS PAC ID | 2860714888 |
|---|---|
| Medicare Enrollment ID | O20141202001996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740692730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | A90876 (California) | Primary |
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