MEDICARE: CHICO ENDOSCOPY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0800X	Endoscopy Clinic/Center		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457357394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICO ENDOSCOPY CENTER

Provider Business Mailing Address
First Line	:	888 LAKESIDE VLG COMMONS
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-3979
Country	:	US
Telephone Number	:	530-332-6810
Fax Number	:	530-899-5743

Provider Business Practice Location Address
First Line	:	888 LAKESIDE VLG COMMONS
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-3979
Country	:	US
Telephone Number	:	530-332-6810
Fax Number	:	530-899-5743

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	WENDY GEIGER
Credential	:
Telephone Number	:	530-332-6810

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/21/2022

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Directions to “CHICO ENDOSCOPY CENTER ” Practice Location

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