NPI Code Detail JSON Logo

1316291867 NPI number — PACIFIC ENDOSCOPY LLC

NPI Number: 1316291867
Health Care Provider/Practitioner: PACIFIC ENDOSCOPY LLC

Information about “1316291867” NPI (PACIFIC ENDOSCOPY LLC) exists in 1316291867 in HTML format HTML  |  1316291867 in plain Text format TXT  |  1316291867 in PDF (Portable Document Format) PDF  |  1316291867 in an XML format XML  formats.

NPI Number : 1316291867 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316291867",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PACIFIC ENDOSCOPY LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3351 EL CAMINO REAL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ATHERTON",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94027-3811",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3351 EL CAMINO REAL",
    "SecondLinePracticeLocationAddress": "STE 220",
    "PracticeLocationAddressCityName": "ATHERTON",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94027-3811",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "650-365-3700",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/06/2012",
    "LastUpdateDate": "11/10/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BOON",
    "AuthorizedOfficialFirstName": "ERIC",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICER/AO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "480-567-0269",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QA1903X",
        "TaxonomyName": "Ambulatory Surgical Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.