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General NPI Number Information
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NPI Number | 1114975794
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Entity Type | Organization
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Legal Business Name | GROSSMONT SURGERY CENTER, L.P.
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8881 FLETCHER PKWY SUITE 100
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City | LA MESA
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State | CA
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Zip | 91942-3134
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Country | US
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Telephone | 619-698-0930
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Fax |
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Provider Business Mailing Address
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Address Line | 8881 FLETCHER PKWY SUITE 100
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City | LA MESA
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State | CA
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Zip | 91942-3134
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Country | US
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Telephone | 619-698-0930
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Fax |
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Authorized Official
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Title or Position | OPS COORDINATOR
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Name | CARRIE JONES
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Credential |
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Telephone | 205-970-5674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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