THE RESERVOIR PHYSICANS SURGERY CENTER, LLC (NPI# 1578729539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578729539 |
| Entity Type | Organization |
| Organization Name | THE RESERVOIR PHYSICANS SURGERY CENTER, LLC |
| Practice Address |
6716 Alvarado Rd San Diego CA 92120 |
| Practice Telephone | 6192873270 |
| Mailing Telephone | 6192873270 |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |
| Authorized Official Name | HARRIS KOENIG (MANAGER) |
| Authorized Official Telephone | 6192873270 |
| Authorized Official Credential | MD |
| 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 |
| Street Address |
6716 ALVARADO RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1225593601 | Truself Training, Inc | Clinic/Center | 5125 Waring Road, San Diego, CA 92120 | 2019-02-09 |
| 1508381799 | Antin Sachs | In Home Supportive Care | 4420 Rainier Avenue, Suite 202, San Diego, CA 92120 | 2017-08-08 |
| 1588186415 | Matthew B Wilbat | Behavioral Analyst | 6851 Alvarado Rd., #17, San Diego, CA 92120 | 2017-07-12 |
| 1548782923 | Mori Khatibzadeh Dds Inc. | Clinic/Center | 6171 Mission Gorge Road, Suite #114, San Diego, CA 92120 | 2017-07-07 |
| 1306379359 | Ken Samith Oerding | Nurse Practitioner | 5422 Reservoir Drive, E7, San Diego Ca, CA 92120 | 2017-04-06 |
| 1396134409 | Debra Michele Stern-ellis | Social Worker | 4647 Zion Avenue Kaiser Permanente, 2nd Floor - Oncology, San Diego, CA 92120 | 2015-01-13 |
| 1821494717 | Shohreh Tourian | Dentist | 7451 Mission Gorge Road, San Diego, CA 92120 | 2014-11-05 |
| 1184049215 | Charles Yin | Counselor | 6153 Fairmount Ave Suite #260, San Diego, CA 92120 | 2014-02-26 |
| Find all providers in zip 92120 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275006173 | Balboa Surgical Institute, Inc. | Clinic/Center | 7625 Mesa College Drive, Suite 315a, San Diego, CA 92111-5343 | 2019-01-03 |
| 1598276404 | Balboa Nephrology Medical Group,inc. | Clinic/Center | 6402 El Cajon Blvd Ste 100, San Diego, CA 92115-2645 | 2017-10-18 |
| 1316462377 | Ucsd Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Pl Ste 100, San Diego, CA 92121-3814 | 2017-08-10 |
| 1710325220 | Carmel Valley Surgical Center | Clinic/Center | 11943 El Camino Real, Suite 100, San Diego, CA 92130-2597 | 2013-06-06 |
| 1346515095 | Medical Acadamy of Hawaii and Anatomical Learning Orginization | Clinic/Center | 5286 Eastgate Mall, San Diego, CA 92121-2815 | 2012-03-14 |
| 1245534460 | The Hilinski Ambulatory Surgery Center | Clinic/Center | 3720 4th Avenue, San Diego, CA 92103 | 2011-01-03 |
| 1538463153 | La Jolla Surgery Center | Clinic/Center | 4510 Executive Dr Ste 200a, San Diego, CA 92121-3023 | 2010-12-23 |
| 1922324177 | Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Place, Suite 100, San Diego, CA 92121-3814 | 2010-04-13 |
| 1194968677 | Professional Surgicenter, Inc | Clinic/Center | 4510 Executive Dr Ste 105a, San Diego, CA 92121-3022 | 2009-04-13 |
| 1528130879 | Pacific Surgical Institute of Pain Management | Clinic/Center | 3703 Camino Del Rio South, Suite 101, San Diego, CA 92108 | 2006-11-14 |
| Find all providers in SAN DIEGO | ||||
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| 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.