Evergreen Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EVERGREEN SURGICAL CENTER, LLC

Practice address

3434 Midway Dr
Suite 1008
San Diego, CA 92110-4923

Phone

(619) 221-0146

Fax

(619) 225-9675

NPI assigned

Mar 14, 2014

Last updated

Mar 14, 2014By 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

Ms. Maureen Jaroscak

Title

Chief Financial Officer

Phone

(424) 279-9481

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1497171342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9461 CHARLEVILLE BLVD",
            "address_2": "SUITE 476",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123017",
            "telephone_number": "424-279-9481",
            "fax_number": "424-279-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR",
            "address_2": "SUITE 1008",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104923",
            "telephone_number": "619-221-0146",
            "fax_number": "619-225-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "JAROSCAK",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "424-279-9481",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashaan Danielle Everett, CNM
• Ruth Jamelia Everett
• Taylor Everett
• Jasmine Everfield, OTD
• Evergreen Psychiatry Inc.
• Kelley Everhart, RN
• Sara Elizabeth Everhart
• Victoria Everich, OTR/L
• Evernorth Direct Health LLC
• Brittany Everroad

• Ambulatory Surgical Clinic/Center in San Diego, CA
• Providers in San Diego, 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 Mar 14, 2014; 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.