Healthcare Provider Details

I. General information

NPI: 1427606383
Provider Name (Legal Business Name): UNITED SURGERY CENTER ENCINITAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 N EL CAMINO REAL STE A210
ENCINITAS CA
92024-1351
US

IV. Provider business mailing address

25150 HANCOCK AVE STE 208
MURRIETA CA
92562-5989
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-8805
  • Fax: 951-698-8898
Mailing address:
  • Phone: 951-698-8805
  • Fax: 951-698-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEN JONES
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 951-698-8805