NPIMap

Organization Active NPI

Reservoir Physicians Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
National Provider Identifier
1427295658
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
RESERVOIR PHYSICIANS SURGERY CENTER, LLC
Practice address
6719 Alvarado Rd
Suite 100
San Diego, CA 92120-5270
Phone
(619) 229-3100
NPI assigned
Jan 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Authorized official

Name
Mr. Harris F Koenig
Title
Chief Executive Officer
Phone
(619) 229-3172

Specialties & licenses 1

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

Addresses

Primary practice location

6719 Alvarado Rd
Suite 100
San Diego, CA 92120-5270

Mailing address

6719 Alvarado Rd
Suite 100
San Diego, CA 92120-5270
Phone (619) 229-3100

National Provider Directory

National Provider Directory

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": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1427295658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205270",
            "telephone_number": "619-229-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 ALVARADO RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205270",
            "telephone_number": "619-229-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESERVOIR PHYSICIANS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "619-229-3172",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.