Provider Demographics
NPI:1497788277
Name:PACIFIC EYE SURGERY CENTER
Entity Type:Organization
Organization Name:PACIFIC EYE SURGERY CENTER
Other - Org Name:PACIFIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-845-6664
Mailing Address - Street 1:2829 W BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2300
Mailing Address - Country:US
Mailing Address - Phone:818-567-0348
Mailing Address - Fax:818-567-2859
Practice Address - Street 1:2829 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2300
Practice Address - Country:US
Practice Address - Phone:818-567-0348
Practice Address - Fax:818-567-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051139Medicare PIN