Organization Active NPI

Inland Empire Outpatient Surgery Center

  • Ambulatory Surgical Clinic/Center
  • San Bernardino, CA
National Provider Identifier
1164640454
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
INLAND EMPIRE OUTPATIENT SURGERY CENTER
Practice address
2150 N Sierra Way
San Bernardino, CA 92405-4030
Phone
(909) 881-2538
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jesse Mitchell, M.D.
Title
Medical Director
Phone
(909) 881-2538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X CA Primary

Addresses

Primary practice location

2150 N Sierra Way
San Bernardino, CA 92405-4030

Mailing address

2150 N Sierra Way
San Bernardino, CA 92405-4030
Phone (909) 881-2538

National Provider Directory

National Provider Directory

Locations

2150 N Sierra Way
Sn Bernrdno, CA 92405
Phone (909) 474-8580

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164640454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 N SIERRA WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054030",
            "telephone_number": "909-881-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N SIERRA WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054030",
            "telephone_number": "909-881-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE OUTPATIENT SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-881-2538",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.