PASADENA ENDOSCOPY CENTER INC NPI 1336247642

NPI Information

NPI: 1336247642
Provider Name: PASADENA ENDOSCOPY CENTER INC
Classification: Clinic/Center - 261QE0800X
Entity Type: Organization

Specialization: Endoscopy

CLIA Number: 05D1001728

Address:
55 W VALLEY ST
PASADENA, CA
ZIP 91105
Phone: (626) 793-9900
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PASADENA ENDOSCOPY CENTER INC is an endoscopy clinic center in Pasadena, CA. PASADENA ENDOSCOPY CENTER INC NPI is 1336247642. The provider is registered as an organization entity type.

The provider's business location address is:

55 W VALLEY ST
PASADENA, CA
ZIP 91105-015
Phone: (626) 793-9900
Fax: (626) 793-9944

The provider's authorized official is Richard Nickowitz .
The authorized official title is President/medical Director and has the following contact phone number (626) 793-9900.

The CLIA number assigned to this NPI record is 05D1001728 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 3/11/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0800X	Clinic/Center	Endoscopy	930000974	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	05C0001537	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
2	490005486	OTHER	CALIFORNIA	RAILROAD MEDICARE PIN
3	S051537	MEDICARE PIN	CALIFORNIA
4	SUR01537F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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