Healthcare Provider Details

I. General information

NPI: 1992879977
Provider Name (Legal Business Name): PACIFIC ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17815 NEWHOPE ST SUITE R
FOUNTAIN VALLEY CA
92708-5426
US

IV. Provider business mailing address

17815 NEWHOPE ST SUITE R
FOUNTAIN VALLEY CA
92708-5426
US

V. Phone/Fax

Practice location:
  • Phone: 714-432-8881
  • Fax: 714-432-8883
Mailing address:
  • Phone: 714-432-8881
  • Fax: 714-432-8883

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. SURINDER S SAINI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 714-429-5800