Eye Surgery Center of Southern California, a Medical Group

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

A85939 Issued in CA

Legal business name

EYE SURGERY CENTER OF SOUTHERN CALIFORNIA, A MEDICAL GROUP

Practice address

2023 W Vista Way
Suite E
Vista, CA 92083-6030

Phone

(760) 941-8152

NPI assigned

Aug 22, 2013

Organization subpart

Yes

Parent organization

EYE SURGERY CENTER OF SOUTHERN CALIFORNIA, A MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Dr. Anuj Gupta, M.D.

Title

Medical Director

Phone

(760) 941-8152

Specialties & licenses 1

Addresses

Other names 1

• Tri City Surgery Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0001020

Legal name

EYE SURGERY CENTER OF SOUTHERN CALIFORNIA, INC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 12, 1983

Last certification

Nov 9, 2018

Ownership / control type

Proprietary

Facility address

2023 W Vista Way #E
Vista, CA 92083

Part of

Eye Surgery Ctr of So Calif

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1285068536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-943-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 W VISTA WAY",
            "address_2": "SUITE E",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836030",
            "telephone_number": "760-941-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGERY CENTER OF SOUTHERN CALIFORNIA, A MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE SURGERY CENTER OF SOUTHERN CALIFORNIA, A MEDICAL GROUP",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ANUJ",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "760-941-8152",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A85939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri City Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-Pharmacy Dispensing Site in Vista, CA
• Providers in Vista, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.