Provider Demographics
NPI:1275857690
Name:SAN DIEGO NEUROSURGEON ONE, APC
Entity Type:Organization
Organization Name:SAN DIEGO NEUROSURGEON ONE, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:K
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-485-8022
Mailing Address - Street 1:9921 CARMEL MOUNTAIN RD
Mailing Address - Street 2:#190
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2813
Mailing Address - Country:US
Mailing Address - Phone:858-485-8022
Mailing Address - Fax:858-815-6820
Practice Address - Street 1:15706 POMERADO RD
Practice Address - Street 2:S 206
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2067
Practice Address - Country:US
Practice Address - Phone:858-485-8022
Practice Address - Fax:858-815-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty