Provider Demographics
NPI:1588867170
Name:CENTRAL ENDOSCOPY CENTER
Entity type:Organization
Organization Name:CENTRAL ENDOSCOPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KISUK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-249-1212
Mailing Address - Street 1:2344 EL CAMINO REAL STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4072
Mailing Address - Country:US
Mailing Address - Phone:408-249-1212
Mailing Address - Fax:408-249-4603
Practice Address - Street 1:2344 EL CAMINO REAL STE 101
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4072
Practice Address - Country:US
Practice Address - Phone:408-249-1212
Practice Address - Fax:408-249-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical