Provider Demographics
NPI:1528385200
Name:ESCONDIDO CA ENDOSCOPY ASC LP
Entity Type:Organization
Organization Name:ESCONDIDO CA ENDOSCOPY ASC LP
Other - Org Name:PARKWAY ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF LP
Authorized Official - Prefix:MS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
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 1:488 E VALLEY PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3363
Practice Address - Country:US
Practice Address - Phone:760-735-6290
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 Licenses
StateLicense IDTaxonomies
CA207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty