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General NPI Number Information
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NPI Number | 1447608088
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Entity Type | Organization
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Legal Business Name | IRVINE ENDOSCOPY PARTNERS LLC
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 16405 SAND CANYON AVE BUILDING A SUITE 110
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City | IRVINE
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State | CA
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Zip | 92618-3785
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Country | US
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Telephone | 801-580-3141
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Fax |
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Provider Business Mailing Address
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Address Line | 16405 SAND CANYON AVE BUILDING A SUITE 110
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City | IRVINE
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State | CA
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Zip | 92618-3785
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Country | US
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Telephone | 801-580-3141
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Fax |
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Authorized Official
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Title or Position | VP OPERATIONS AND DEVELOPMENT
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Name | BARBARA H BOWEN
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Credential |
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Telephone | 801-580-3141
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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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