Colima Endoscopy Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

05C0001387 Issued in CA

Legal business name

COLIMA ENDOSCOPY CENTER INC

Doing business as

Colima Endoscopy Center

Practice address

1900 S Brea Canyon Rd Unit a
Diamond Bar, CA 91765-4059

Phone

(626) 913-1116

Fax

(626) 913-1261

NPI assigned

Oct 17, 2005

Last updated

Jun 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sung Jun Yoo, M.DNPI 1437141587

Title

Medical Director

Phone

(626) 913-1116

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Colima Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Colima Endoscopy Center IncCCN 05C0001387

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sung J Yoo, MD

  • Gastroenterology Physician
  • Diamond Bar, CA
  • NPI 1437141587
  Authorized official Same address or phone

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1275522849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S BREA CANYON RD UNIT A",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654059",
            "telephone_number": "626-913-1116",
            "fax_number": "626-913-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S BREA CANYON RD UNIT A",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654059",
            "telephone_number": "626-913-1116",
            "fax_number": "626-913-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIMA ENDOSCOPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "SUNG",
        "authorized_official_middle_name": "JUN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "626-913-1116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "05C0001387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AMBULATORY SURGICAL CENTER CERTIFICATION",
            "identifier": "05C0001387",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01387F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colima Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.