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General NPI Number Information
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NPI Number | 1760440515
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Entity Type | Organization
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Legal Business Name | SIERRA ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 300 SIERRA COLLEGE DR STE.105
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5082
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Country | US
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Telephone | 530-273-0527
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Fax |
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Provider Business Mailing Address
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Address Line | 300 SIERRA COLLEGE DR STE 105
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5084
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Country | US
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Telephone | 530-273-0527
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Fax |
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | ERIC BOON
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Credential |
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Telephone | 480-567-0269
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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 | 230000350
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License Number State | CA
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