Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) accredited bariatric center operated by Scripps Clinic — founded 1924 — the Fourth Avenue office at 4060 Fourth Avenue Suite 330 in Hillcrest 92103 runs weight-loss surgery built on the 20,000+ bariatric case volume accumulated by the surgeon group formerly known as Pacific Bariatric Surgical Medical Group. Procedural scope covers Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, adjustable gastric band removal and revision, and bariatric surgical revisions for failed prior weight-loss operations, with non-surgical medical weight management cases routed through MedArts Weight Loss Specialists when patients don't meet BMI or comorbidity thresholds for surgery. Surgeons Dr. William Fuller, Dr. Gabriela Jordan, Dr. Lian Lim, and Dr. Jennie Luna staff the program, with Dr. Lim holding robotic-surgery certification for minimally invasive general surgery cases including hernia repair, gallbladder removal, and abdominal-wall reconstruction. The program serves as the contracted bariatric surgery site for Kaiser Permanente health-plan members in San Diego County, meaning Kaiser-insured patients meeting medical criteria receive their weight-loss surgery through this office with inpatient stays at Scripps Mercy Hospital San Diego across the street. Preoperative workup includes psychological evaluation, nutrition counseling, resting metabolic rate testing, and medically supervised diet trials before surgical authorization. The most complex cases are revisional bariatric operations converting failed prior gastric bands or sleeve gastrectomies into Roux-en-Y gastric bypass anatomy in patients with weight regain, reflux, or anatomical complications.