Healthcare Provider Details

I. General information

NPI: 1780688499
Provider Name (Legal Business Name): THE CENTER FOR ENDOSCOPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 WARING RD STE B
OCEANSIDE CA
92056-4456
US

IV. Provider business mailing address

3921 WARING RD STE B
OCEANSIDE CA
92056-4456
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-6300
  • Fax: 760-940-8074
Mailing address:
  • Phone: 760-940-6300
  • Fax: 760-940-8074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRIS L BLANKENHORN
Title or Position: OFFICE MANAGER
Credential:
Phone: 760-940-6300