Provider Demographics
NPI:1255658928
Name:GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER. LLC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER. LLC
Other - Org Name:REDDING ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CLENDENIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:20 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6197
Mailing Address - Country:US
Mailing Address - Phone:615-240-3820
Mailing Address - Fax:
Practice Address - Street 1:1825 SONOMA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2519
Practice Address - Country:US
Practice Address - Phone:530-246-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty