Provider Demographics
NPI:1700816733
Name:ADVANCED ENDOSCOPY CENTER INC
Entity Type:Organization
Organization Name:ADVANCED ENDOSCOPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNNANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-724-9900
Mailing Address - Street 1:386 W OLIVE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3137
Mailing Address - Country:US
Mailing Address - Phone:209-724-9900
Mailing Address - Fax:209-724-9901
Practice Address - Street 1:386 W OLIVE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3137
Practice Address - Country:US
Practice Address - Phone:209-724-9900
Practice Address - Fax:209-724-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000497261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy