SAN DIEGO SKIN INC. NPI 1972831998

NPI Information

NPI: 1972831998
Provider Name: SAN DIEGO SKIN, INC.
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D2055590

Address:
4150 REGENTS PARK ROW
SUITE 300
LA JOLLA, CA
ZIP 92037
Phone: (858) 909-9000
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SAN DIEGO SKIN, INC. is an ambulatory surgical clinic center in La Jolla, CA. SAN DIEGO SKIN, INC. NPI is 1972831998. The provider is registered as an organization entity type.

The provider's business location address is:

4150 REGENTS PARK ROW
SUITE 300
LA JOLLA, CA
ZIP 92037-124
Phone: (858) 909-9000
Fax: (858) 909-9009

The provider's authorized official is M. Mark Mofid .
The authorized official title is President and has the following contact phone number (858) 909-9000.

The CLIA number assigned to this NPI record is 05D2055590 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/2/2009 and was last updated on 12/2/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	A83432	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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