EVERGREEN SURGICAL CENTER LLC NPI 1497171342

NPI Information

NPI: 1497171342
Provider Name: EVERGREEN SURGICAL CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
3434 MIDWAY DR
SUITE 1008
SAN DIEGO, CA
ZIP 92110
Phone: (619) 221-0146
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EVERGREEN SURGICAL CENTER, LLC is an ambulatory surgical clinic center in San Diego, CA. EVERGREEN SURGICAL CENTER, LLC NPI is 1497171342. The provider is registered as an organization entity type.

The provider's business location address is:

3434 MIDWAY DR
SUITE 1008
SAN DIEGO, CA
ZIP 92110-923
Phone: (619) 221-0146
Fax: (619) 225-9675

The provider's authorized official is Maureen Jaroscak .
The authorized official title is Chief Financial Officer and has the following contact phone number (424) 279-9481.

The enumeration date for this NPI number is 3/14/2014 and was last updated on 3/14/2014.

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	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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

NPI Synchronization or Removal

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