Provider Demographics
NPI:1831806405
Name:ENTERSURG PC
Entity type:Organization
Organization Name:ENTERSURG PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ZARKOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-304-0117
Mailing Address - Street 1:PO BOX 5000
Mailing Address - Street 2:PMB 54
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067
Mailing Address - Country:US
Mailing Address - Phone:720-705-0682
Mailing Address - Fax:
Practice Address - Street 1:591 E ELDER ST STE B
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-5001
Practice Address - Country:US
Practice Address - Phone:858-304-0117
Practice Address - Fax:760-309-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty