Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

La Jolla Professional Plastic Surgery

Organization Plastic Surgery Physician · NPI 1396383212

La Jolla Professional Plastic Surgery is a Plastic Surgery Physician in San Diego, California. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

4510 Executive Dr Ste 105
San Diego, CA 92121
Phone: (858) 457-8686
Fax: (858) 450-7690
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1396383212
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ron Soltero — President · (858) 457-8686
NPI enumeratedDecember 11, 2019
Last updated in NPPESDecember 11, 2019
Certification dateDecember 11, 2019
Mailing address4510 Executive Dr. Suite 105, San Diego, CA 92121

Other providers in San Diego