Provider Demographics
NPI:1639694797
Name:UCSD CENTER FOR SURGERY OF ENCINITAS, L.P.
Entity Type:Organization
Organization Name:UCSD CENTER FOR SURGERY OF ENCINITAS, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPRARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-472-7434
Mailing Address - Street 1:477 N EL CAMINO REAL STE 100
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-942-8800
Mailing Address - Fax:
Practice Address - Street 1:477 N EL CAMINO REAL STE 100
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-942-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical