San Diego Endoscopy Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SAN DIEGO ENDOSCOPY CENTER

Practice address

4033 3Rd Ave
Suite 106
San Diego, CA 92103-2117

Phone

(619) 497-2888

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Richard L Sharff Jr.

Title

VP/Secretary

Phone

(205) 545-2572

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

San Diego Endoscopy CenterCCN 05C0001247

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

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1952368482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 3RD AVE",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 3RD AVE",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032117",
            "telephone_number": "619-497-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "SHARFF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP/SECRETARY",
        "authorized_official_telephone_number": "205-545-2572",
        "authorized_official_name_suffix": "Jr."
    },
    "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 San Diego, CA
• Providers in San Diego, 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 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.