| Organization Name: | CERRITOS ENDOSCOPIC MEDICAL CENTER, INC. |
| NPI Number: | 1033226600 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAESOO PAK (MEDICAL DIRECTOR) |
| Mailing Address: | 11845 South St Cerritos |
| State: | CA US |
| Postal Code: | 907036825 |
| Phone Number: | 5628098082 |
| Fax Number: | |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 01/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | W22596 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |