EVERGREEN SURGICAL CENTER, LLC


Address: 3434 Midway Dr, Suite 1008, San Diego, CA 92110-4923
Phone: 6192210146

EVERGREEN SURGICAL CENTER, LLC (NPI# 1497171342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497171342
Entity Type Organization
Organization Name EVERGREEN SURGICAL CENTER, LLC
Practice Address 3434 Midway Dr
Suite 1008
San Diego
CA 92110-4923
Mailing Address 9461 Charleville Blvd
Suite 476
Beverly Hills
CA 90212-3017
Practice Telephone 6192210146
Practice Fax Number 6192259675
Mailing Telephone 4242799481
Mailing Fax Number 4242799482
Enumeration Date 2014-03-14
Last Update Date 2014-03-14
Authorized Official Name MS. MAUREEN JAROSCAK (CHIEF FINANCIAL OFFICER)
Authorized Official Telephone 4242799481
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
Ambulatory Health Care Facilities

Office Location

Street Address 3434 MIDWAY DR
SUITE 1008
City SAN DIEGO
State CA
Zip Code 92110-4923

Providers in the same location

NPI Name Taxonomy Address Enumeration
1346241452 Mark J Tamsen Emergency Medicine 3434 Midway Dr, Ste 1002, San Diego, CA 92110-4923 2005-08-10
1114312543 Kelsey Quinn Gaffney Physical Therapist 3434 Midway Dr, Suite 2005a, San Diego, CA 92110-4923 2015-04-02
1720386519 San Diego Surgery LLC Specialist 3434 Midway Dr, 1008, San Diego, CA 92110-4923 2011-03-03
1992003784 San Diego Ultrasound LLC Specialist 3434 Midway Dr, Suite 1008, San Diego, CA 92110-4923 2011-03-03
1346547767 San Diego Gastroenterology LLC Specialist 3434 Midway Dr, Suite 1008, San Diego, CA 92110-4923 2011-02-21
1912239013 San Diego Ambulatory Surgery Center LLC Clinic/Center 3434 Midway Dr, Suite 1006, San Diego, CA 92110-4923 2010-02-01
1073783064 Richard C. Richley M.d. Inc Specialist 3434 Midway Dr, Suite 2001, San Diego, CA 92110-4923 2008-03-05
1518097344 David M. Kupfer, M.d., Inc. Plastic Surgery 3434 Midway Dr, Suite 2004, San Diego, CA 92110-4923 2007-03-07
1760581342 Outpatient Surgery of Point Loma Clinic/Center 3434 Midway Dr, #1006, San Diego, CA 92110-4923 2006-09-21
1851314660 Richard C Richley Specialist 3434 Midway Dr, Suite 2001, San Diego, CA 92110-4923 2006-07-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669021713 Ruben Daniel Gutierrez Marriage & Family Therapist 4141 Pacific Coast Hwy, San Diego, CA 92110 2019-09-10
1548724081 Denise Ellen Thompson Counselor 3255 Wings Street, San Diego, CA 92110 2019-01-29
1801378716 Michelle Lisa Jean Crawford Student in an Organized Health Care Education/Training Program 3767 Central Avenue, San Diego, CA 92110 2018-09-06
1427539048 Allison Turrell Case Manager/Care Coordinator 4930 Naples Street, San Diego, CA 92110 2018-08-22
1750872768 Matthew Langworthy Physical Therapist 3405 Kenyon St Ste 212, San Diego, CA 92110 2018-05-24
1245748342 The One Health Boutique, LLC Chiropractor 5350 Riley St, San Diego, CA 92110 2018-01-11
1437670155 Monique A Fernandez Counselor 3132 Jefferson Street, San Diego, CA 92110 2017-07-03
1538510391 Mayu Winters Registered Nurse 853 Rosecrans St, San Diego, CA 92110 2016-06-23
1376998864 Briniti Ichull Specialist 3941 Kurtz St, San Diego, CA 92110 2016-05-03
1912352576 Healthcare Services, Inc. Substance Abuse Rehabilitation Facility 3880 Rosecrans Street, San Diego, CA 92110 2016-05-02
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275006173 Balboa Surgical Institute, Inc. Clinic/Center 7625 Mesa College Drive, Suite 315a, San Diego, CA 92111-5343 2019-01-03
1598276404 Balboa Nephrology Medical Group,inc. Clinic/Center 6402 El Cajon Blvd Ste 100, San Diego, CA 92115-2645 2017-10-18
1316462377 Ucsd Surgical Center of San Diego, LLC Clinic/Center 4910 Directors Pl Ste 100, San Diego, CA 92121-3814 2017-08-10
1710325220 Carmel Valley Surgical Center Clinic/Center 11943 El Camino Real, Suite 100, San Diego, CA 92130-2597 2013-06-06
1346515095 Medical Acadamy of Hawaii and Anatomical Learning Orginization Clinic/Center 5286 Eastgate Mall, San Diego, CA 92121-2815 2012-03-14
1245534460 The Hilinski Ambulatory Surgery Center Clinic/Center 3720 4th Avenue, San Diego, CA 92103 2011-01-03
1538463153 La Jolla Surgery Center Clinic/Center 4510 Executive Dr Ste 200a, San Diego, CA 92121-3023 2010-12-23
1922324177 Surgical Center of San Diego, LLC Clinic/Center 4910 Directors Place, Suite 100, San Diego, CA 92121-3814 2010-04-13
1194968677 Professional Surgicenter, Inc Clinic/Center 4510 Executive Dr Ste 105a, San Diego, CA 92121-3022 2009-04-13
1578729539 The Reservoir Physicans Surgery Center, LLC Clinic/Center 6716 Alvarado Rd, San Diego, CA 92120 2008-07-30
Find all providers in SAN DIEGO

Competitor

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City SAN DIEGO
Zip Code 92110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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