SAN DIEGO SPORTS AND MINIMALLY INVASIVE SURGERY CENTER LLC (NPI# 1801045430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801045430 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO SPORTS AND MINIMALLY INVASIVE SURGERY CENTER LLC |
| Other Organization Name | SMI SURGERY CENTER |
| Practice Address |
3939 Ruffin Rd Suite 100 San Diego CA 92123-1815 |
| Practice Telephone | 8584494071 |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |
| Authorized Official Name | MR. MARC D JANG (PRESIDENT & CEO) |
| Authorized Official Telephone | 9166143608 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SMI Surgery Center | Doing Business As Name - Organization |
| Street Address |
3939 RUFFIN RD SUITE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598730335 | Kristi Ann Dove | Psychiatry & Neurology | 3939 Ruffin Rd, San Diego, CA 92123-1802 | 2006-02-22 |
| 1194279430 | Ibreathe, Inc. | Durable Medical Equipment & Medical Supplies | 3939 Ruffin Rd, San Diego, CA 92123-1802 | 2016-08-03 |
| 1659702413 | Nicole Lee Diggs | Massage Therapist | 3939 Ruffin Rd, San Diego, CA 92123-1802 | 2013-12-04 |
| 1396082483 | Paul Richard Hodge | Physical Therapist | 3939 Ruffin Rd, Ste 103, San Diego, CA 92123-1802 | 2013-01-09 |
| 1972858462 | Lauren Victoria Lederer | Physical Therapist | 3939 Ruffin Rd, Suite 103, San Diego, CA 92123-1802 | 2012-07-20 |
| 1164799326 | Physiotherapy Associates Inc | Clinic/Center | 3939 Ruffin Rd, Suite 103, San Diego, CA 92123-1804 | 2011-11-16 |
| 1124342431 | Smi Imaging Center of San Diego, LLC | Specialist | 3939 Ruffin Rd, Suite 102, San Diego, CA 92123-1815 | 2010-03-16 |
| 1982743613 | Byron King, Md, Inc. | Neuromusculoskeletal Medicine, Sports Medicine | 3939 Ruffin Rd, Suite 101, San Diego, CA 92123-1815 | 2007-02-06 |
| 1851309314 | Alicja Steiner | Anesthesiology | 3939 Ruffin Rd, San Diego, CA 92123-1815 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275006173 | Balboa Surgical Institute, Inc. | Clinic/Center | 7625 Mesa College Drive, Suite 315a, San Diego, CA 92111-5343 | 2019-01-03 |
| 1598276404 | Balboa Nephrology Medical Group,inc. | Clinic/Center | 6402 El Cajon Blvd Ste 100, San Diego, CA 92115-2645 | 2017-10-18 |
| 1316462377 | Ucsd Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Pl Ste 100, San Diego, CA 92121-3814 | 2017-08-10 |
| 1710325220 | Carmel Valley Surgical Center | Clinic/Center | 11943 El Camino Real, Suite 100, San Diego, CA 92130-2597 | 2013-06-06 |
| 1346515095 | Medical Acadamy of Hawaii and Anatomical Learning Orginization | Clinic/Center | 5286 Eastgate Mall, San Diego, CA 92121-2815 | 2012-03-14 |
| 1245534460 | The Hilinski Ambulatory Surgery Center | Clinic/Center | 3720 4th Avenue, San Diego, CA 92103 | 2011-01-03 |
| 1538463153 | La Jolla Surgery Center | Clinic/Center | 4510 Executive Dr Ste 200a, San Diego, CA 92121-3023 | 2010-12-23 |
| 1922324177 | Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Place, Suite 100, San Diego, CA 92121-3814 | 2010-04-13 |
| 1194968677 | Professional Surgicenter, Inc | Clinic/Center | 4510 Executive Dr Ste 105a, San Diego, CA 92121-3022 | 2009-04-13 |
| 1578729539 | The Reservoir Physicans Surgery Center, LLC | Clinic/Center | 6716 Alvarado Rd, San Diego, CA 92120 | 2008-07-30 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.