Eastside Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EASTSIDE SURGERY CENTER, LLC

Practice address

16390 N 59TH Ave Ste 100
Glendale, AZ 85306-1711

Phone

(623) 298-1820

Fax

(602) 595-0968

NPI assigned

May 7, 2020

Organization subpart

No

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

Authorized official

Name

David F Berg, DC

Title

Owner

Phone

(623) 334-4000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1902428477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13430 N SCOTTSDALE RD STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544058",
            "telephone_number": "623-334-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16390 N 59TH AVE STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061711",
            "telephone_number": "623-298-1820",
            "fax_number": "602-595-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-334-4000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Glendale, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.