Provider Demographics
NPI:1447608088
Name:IRVINE ENDOSCOPY PARTNERS LLC
Entity Type:Organization
Organization Name:IRVINE ENDOSCOPY PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS AND DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-580-3141
Mailing Address - Street 1:16405 SAND CANYON AVE
Mailing Address - Street 2:BUILDING A SUITE 110
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3785
Mailing Address - Country:US
Mailing Address - Phone:801-580-3141
Mailing Address - Fax:
Practice Address - Street 1:16405 SAND CANYON AVE
Practice Address - Street 2:BUILDING A SUITE 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3785
Practice Address - Country:US
Practice Address - Phone:801-580-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical