Eclipsesurg Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A133496 Issued in CA

Legal business name

ECLIPSESURG INC

Practice address

160 Blue Jay LN
Redlands, CA 92374-1651

Phone

(269) 547-0500

NPI assigned

Oct 26, 2016

Last updated

Oct 26, 2016By 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

Dr. Olivier Urayeneza, MD

Title

President

Phone

(269) 547-0500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1871045740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BLUE JAY LN",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923741651",
            "telephone_number": "269-547-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BLUE JAY LN",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923741651",
            "telephone_number": "269-547-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECLIPSESURG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "URAYENEZA",
        "authorized_official_first_name": "OLIVIER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-547-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A133496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A133496",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.