Provider Demographics
NPI:1740409721
Name:TORREY HILLS SURGICAL SPECIALTIES
Entity Type:Organization
Organization Name:TORREY HILLS SURGICAL SPECIALTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:NOUSHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOAEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:858-481-8240
Mailing Address - Street 1:4765 CARMEL MOUNTAIN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6657
Mailing Address - Country:US
Mailing Address - Phone:858-481-8248
Mailing Address - Fax:858-481-8612
Practice Address - Street 1:4765 CARMEL MOUNTAIN RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6657
Practice Address - Country:US
Practice Address - Phone:858-481-8248
Practice Address - Fax:858-481-8612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94751204E00000X
CAE4631213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
Not Answered213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty