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General NPI Number Information
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NPI Number | 1518984301
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Entity Type | Organization
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Legal Business Name | ENDOSCOPY CENTER OF INLAND EMPIRE INC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 40404 CALIFORNIA OAKS RD STE A
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City | MURRIETA
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State | CA
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Zip | 92562-5786
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Country | US
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Telephone | 785-215-8777
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Fax | 785-215-8773
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Provider Business Mailing Address
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Address Line | 40404 CALIFORNIA OAKS RD STE A
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City | MURRIETA
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State | CA
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Zip | 92562-5786
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Country | US
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Telephone | 785-215-8777
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Fax | 785-215-8773
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Authorized Official
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Title or Position | DIRECTOR OF MEDICAL BILLING
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Name | MRS. LIZ A SHEPHERD
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Credential |
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Telephone | 785-215-8777
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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 | 250000794
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License Number State | CA
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