OTAY LAKES SURGERY CENTER, LLC (NPI# 1376595421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376595421 |
| Entity Type | Organization |
| Organization Name | OTAY LAKES SURGERY CENTER, LLC |
| Practice Address |
955 Lane Ave Suite 100 Chula Vista CA 91914-3501 |
| Practice Telephone | 6197542260 |
| Practice Fax Number | 6197542261 |
| Mailing Telephone | 6197542260 |
| Mailing Fax Number | 6197542261 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GARY KURTH (VP OPERATIONS AND ADMINISTRATION) |
| Authorized Official Telephone | 6197542260 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SUR01779F | 05 |
| Street Address |
955 LANE AVE SUITE 100 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91914-3501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013992866 | Joseph Edward Bailey | Physical Therapist | 955 Lane Ave, #201, Chula Vista, CA 91914-3501 | 2005-12-14 |
| 1326599531 | Reiko Takahashi | Physical Therapist | 955 Lane Ave, 201, Chula Vista, CA 91914-4525 | 2016-10-23 |
| 1679952485 | Synergy Specialists Medical Group | Specialist | 955 Lane Ave, Suite 200, Chula Vista, CA 91914-4525 | 2015-05-26 |
| 1740559509 | Gemma Bajaro | Physical Therapist | 955 Lane Ave, Suite 201, Chula Vista, CA 91914-4525 | 2011-12-23 |
| 1326363011 | Manual Orthopedic Physical Therapy Inc | Physical Therapist | 955 Lane Ave, 201, Chula Vista, CA 91914-4525 | 2010-04-06 |
| 1548438229 | Anthony G. Sanzone Md, Inc | Specialist | 955 Lane Ave, Suite 200, Chula Vista, CA 91914-4525 | 2008-02-14 |
| 1558466086 | Michael Kevin Stein | Physical Therapist | 955 Lane Ave, Ste 201, Chula Vista, CA 91914-3501 | 2006-09-13 |
| 1699711846 | Michael R Lenihan | Specialist | 955 Lane Ave, Suite 200, Chula Vista, CA 91914-3501 | 2006-06-22 |
| 1992747059 | Anthony G Sanzone | Orthopaedic Surgery | 955 Lane Ave, Suite 200, Chula Vista, CA 91914-4525 | 2006-06-12 |
| 1669414850 | Mark T Selecky | Specialist | 955 Lane Ave, Suite 200, Chula Vista, CA 91914-3501 | 2006-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447785811 | Tania Marie Beaudoin | Social Worker | 2580 Catamaran Way Ste 103, Chula Vista, CA 91914 | 2017-04-24 |
| 1477090447 | Leaha Elrod | Speech-Language Pathologist | 2985 Stevenson Ranch Ct, Chula Vista, CA 91914 | 2017-01-27 |
| 1205382934 | Jessica Lexanne Morris | Occupational Therapy Assistant | 861 Harold Pl, Chula Vista, Chula Vista, CA 91914 | 2016-09-01 |
| 1821457169 | Eagles Wings Home Care Inc. | Clinic/Center | 2529 Saddlehorn Dr., Chula Vista, CA 91914 | 2016-02-15 |
| 1609217355 | Joanna Sarao Songcuan | Marriage & Family Therapist | 2400 Fenton St Ste 217, Chula Vista, CA 91914 | 2013-07-10 |
| 1891043477 | Deanna Risos Dmd,pc. | Dentist | 841 Kuhn Dr. Ste # 102, Chula Vista, CA 91914 | 2012-08-29 |
| 1417262718 | Lisa Alvarez | Nurse Practitioner | 891 Bryce Ave, Chula Vista, CA 91914 | 2010-08-11 |
| 1164669123 | Guadalupe Marquez | Dentist | 2452 Fenton St Ste 200, Chula Vista, CA 91914 | 2009-01-13 |
| 1750537379 | Christina Marie Morris | Registered Nurse | 595 Northbrook Ave., Chula Vista, CA 91914 | 2008-08-14 |
| 1114113008 | Adrian Avila | Marriage & Family Therapist | 2560 Catamaran Way, Chula Vista, CA 91914 | 2007-09-24 |
| Find all providers in zip 91914 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568814010 | Surgery Center of California -llc | Clinic/Center | 835 3rd Ave Ste A, Chula Vista, CA 91911-1352 | 2016-07-08 |
| 1659657856 | Alfa Surgery Center, LLC | Clinic/Center | 256 Landis Ave, Ste 100, Chula Vista, CA 91910-2650 | 2011-11-01 |
| 1457535395 | Eastlake Surgery Center | Clinic/Center | 890 Eastlake Pkwy, Suite #100, Chula Vista, CA 91914-4520 | 2007-12-27 |
| 1649476805 | Ruben Edward Sanchez | Clinic/Center | 754 Medical Center Ct, Suite 203, Chula Vista, CA 91911-6654 | 2007-06-25 |
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|---|---|---|---|---|
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| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
| City | CHULA VISTA |
| Zip Code | 91914 |
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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.