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General NPI Number Information
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NPI Number | 1417935206
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE CENTER, LP
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 08/03/2017
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Provider Practice Location Address
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Address Line | 24411 HEALTH CENTER DR SUITE 450
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3633
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Country | US
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Telephone | 949-586-9386
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Fax | 949-586-0864
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Provider Business Mailing Address
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Address Line | 24411 HEALTH CENTER DR SUITE 450
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3633
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Country | US
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Telephone | 949-586-9386
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Fax | 949-586-0864
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CAROLYN KNUTZEN
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Credential |
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Telephone | 949-586-9386
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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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