NPI | 1174552632 |
---|---|
Doing Business As | EL PORTAL ENDOSURGERY CENTER |
Entity Type | Organization |
Authorized Contact | REBECCA L SHAW CEO 209-723-1920 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2006-06-30 |
Last Update Date | 2014-07-21 |