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General NPI Number Information
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NPI Number | 1285863696
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Entity Type | Organization
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Legal Business Name | TEMECULA CA ENDOSCOPY ASC LP
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 25150 HANCOCK AVE SUITE 208
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City | MURRIETA
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State | CA
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Zip | 92562-5987
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Country | US
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Telephone | 951-698-8805
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Fax | 951-698-8898
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Provider Business Mailing Address
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Address Line | 25150 HANCOCK AVE SUITE 208
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City | MURRIETA
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State | CA
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Zip | 92562-5987
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Country | US
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Telephone | 951-698-8805
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Fax | 951-698-8898
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | KENNETH JONES
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Credential |
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Telephone | 951-698-8805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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