Estea Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ESTEA AMBULATORY SURGERY CENTER, LLC

Practice address

3440 Atlantic Ave Ste 3
Long Beach, CA 90807-4568

Phone

(562) 595-6961

Fax

(562) 595-8430

NPI assigned

Mar 30, 2020

Organization subpart

No

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

Authorized official

Name

Jiri Konecny, DO

Title

Medical Director

Phone

(562) 595-6961

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1598393076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 ATLANTIC AVE STE 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074568",
            "telephone_number": "562-595-6961",
            "fax_number": "562-595-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 ATLANTIC AVE STE 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074568",
            "telephone_number": "562-595-6961",
            "fax_number": "562-595-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTEA AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "KONECNY",
        "authorized_official_first_name": "JIRI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-595-6961",
        "authorized_official_credential": "DO"
    },
    "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 Long Beach, CA
• Providers in Long Beach, 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 30, 2020; 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.