Healthcare Provider Details

I. General information

NPI: 1326147018
Provider Name (Legal Business Name): ELITE SURGICAL CENTERS, ESCONDIDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 E VALLEY PKWY #110
ESCONDIDO CA
92025-3363
US

IV. Provider business mailing address

12021 WILSHIRE BLVD #864
LOS ANGELES CA
90025-1206
US

V. Phone/Fax

Practice location:
  • Phone: 619-223-0910
  • Fax:
Mailing address:
  • Phone: 310-440-3131
  • Fax: 310-472-9582

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: DR. DAVID KUPFER
Title or Position: OWNER
Credential: M.D.
Phone: 619-223-2271