Endoscopy Surgery Center of Santa Maria

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ENDOSCOPY SURGERY CENTER OF SANTA MARIA

Practice address

116 S Palisade Dr
Suite 110
Santa Maria, CA 93454-8904

Phone

(805) 614-5220

Fax

(805) 614-5221

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By 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

Bruce F Mize, M.D.

Title

Medical Director

Phone

(805) 614-5220

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912004193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR",
            "address_2": "SUITE 110",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548904",
            "telephone_number": "805-614-5220",
            "fax_number": "805-614-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR",
            "address_2": "SUITE 110",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548904",
            "telephone_number": "805-614-5220",
            "fax_number": "805-614-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY SURGERY CENTER OF SANTA MARIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIZE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "805-614-5220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01426G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, 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 Aug 22, 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.