The Reservoir Physicans Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

THE RESERVOIR PHYSICANS SURGERY CENTER, LLC

Practice address

6716 Alvarado Rd
San Diego, CA 92120

Phone

(619) 287-3270

NPI assigned

Jul 30, 2008

Organization subpart

No

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

Authorized official

Name

Harris Koenig, MD

Title

Manager

Phone

(619) 287-3270

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1578729539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6716 ALVARADO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-287-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6716 ALVARADO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-287-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RESERVOIR PHYSICANS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "619-287-3270",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jul 30, 2008; 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.