Healthcare Provider Details

I. General information

NPI: 1336143734
Provider Name (Legal Business Name): TORRANCE ENDOSCOPY AND SURGICAL AFFILIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23441 MADISON ST STE 230
TORRANCE CA
90505-4757
US

IV. Provider business mailing address

23441 MADISON ST STE 230
TORRANCE CA
90505-4757
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-6461
  • Fax: 310-375-7201
Mailing address:
  • Phone: 310-375-6461
  • Fax: 310-375-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE GARCIA
Title or Position: HR
Credential:
Phone: 310-375-1246