ENDOSCOPY CENTER OF SOUTH SACRAMENTO, LLC (NPI# 1487136412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487136412 |
| Entity Type | Organization |
| Organization Name | ENDOSCOPY CENTER OF SOUTH SACRAMENTO, LLC |
| Other Organization Name | ENDOSCOPY CENTER OF SOUTH SACRAMENTO |
| Practice Address |
8120 Timberlake Way Ste 103 Sacramento CA 95823-5413 |
| Mailing Address |
15305 Dallas Pkwy Ste 1600 Addison TX 75001-6491 |
| Practice Telephone | 9166812350 |
| Practice Fax Number | 9166812370 |
| Mailing Telephone | 9727633893 |
| Mailing Fax Number | 9726926745 |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2019-04-09 |
| Authorized Official Name | JENETHA MORAN (AUTHORIZED OFFICIAL / OFFICER) |
| Authorized Official Telephone | 9727633893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ENDOSCOPY CENTER OF SOUTH SACRAMENTO | Doing Business As Name - Organization |
| Street Address |
8120 TIMBERLAKE WAY STE 103 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-5413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730563610 | Sacramento Midtown Endoscopy Center, LLC | Clinic/Center | 3941 J St Ste 460, Sacramento, CA 95819-3633 | 2015-07-10 |
| 1134449382 | Lisa H. Hwang | Clinic/Center | The Plastic Surgery Center, 95 Scripps Drive, Sacramento, CA 95825 | 2010-06-09 |
| 1710127774 | Northern California Advanced Surgery Center Lp | Clinic/Center | 5771 Greenback Ln, Sacramento, CA 95841-2013 | 2009-03-03 |
| 1649434515 | Jagdev Singh Heir,md A Professional Corporation | Clinic/Center | 4170 Truxel Rd Ste C, Sacramento, CA 95834-3758 | 2008-07-10 |
| 1285696500 | Sutter Surgery Center Lp | Clinic/Center | 75 Scripps Dr, Sacramento, CA 95825-6320 | 2006-04-03 |
| 1780689802 | Pain Diagnostic and Treatment Center Lp | Clinic/Center | 2805 J. St, Ste 200, Sacramento, CA 95816-4307 | 2005-06-15 |
| 1114921541 | Sacramento Surgery Center Assoc., Lp | Clinic/Center | 1800 Tribute Rd, Ste 100, Sacramento, CA 95815-4314 | 2005-06-13 |
| 1295739134 | Michael J Fazio, Md, Surgery Center | Clinic/Center | 2805 J St, Ste 100, Sacramento, CA 95816-4307 | 2005-06-09 |
| 1336510486 | Sacramento Heart Ambulatory Surgery Center, Inc | Clinic/Center | 500 University Ave, Sacramento, CA 95825-6504 | 2015-10-15 |
| 1497130660 | Nivano Ambulatory Surgery Center, Lp | Clinic/Center | 77 Cadillac Dr, Suite 130, Sacramento, CA 95825-5453 | 2015-07-29 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
Please comment or provide details below to improve the information on ENDOSCOPY CENTER OF SOUTH SACRAMENTO, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.