Grand Gi & Endoscopy Group, Inc.

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

A92866 Issued in CA

Legal business name

GRAND GI & ENDOSCOPY GROUP, INC.

Practice address

505 S Virgil Ave
Suite 104
Los Angeles, CA 90020-1406

Phone

(213) 381-3630

Fax

(213) 381-3631

NPI assigned

Jan 2, 2014

Organization subpart

No

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

Authorized official

Name

Nary L Cheng

Title

Office Manager

Phone

(213) 381-3630

Specialties & licenses 1

Addresses

Other names 1

• Grand Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospital certification: CCN 050801

Legal name

GRAND ENDOSCOPY CENTER

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

May 19, 2020

Last certification

May 19, 2020

Beds

1

Ownership / control type

Private (for profit)

Facility address

505 South Virgil Ave, Suite 104
Los Angeles, CA 90020

Listed as

Grand Gi and Endoscopy Group IncCCN 05C0002074

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1871914291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE",
            "address_2": "SUITE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201406",
            "telephone_number": "213-381-3630",
            "fax_number": "213-381-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE",
            "address_2": "SUITE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201406",
            "telephone_number": "213-381-3630",
            "fax_number": "213-381-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND GI & ENDOSCOPY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "NARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "213-381-3630"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "CA",
            "license": "A92866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grancare LLC
• Grand Anesthesia and Nursing Services Inc
• Grand Avenue Imaging
• Grand Avenue Surgery Center, LLC
• Grand Gi & Endoscopy Group, Inc.
• Grand Park SNF Operator LLC
• Grand Pharmacy., Inc
• Grand Pharmacy., Inc
• Grand Solutions Inc.
• Grand Venice LLC

• Endoscopy Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Endoscopy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.