| Organization Name: | LOS ALAMOS NM ENDOSCOPY ASC LLC |
| NPI Number: | 1306810692 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER A HOLDEN (CHIEF MANAGER OF LLC) |
| Mailing Address: | 1911 Central Ave Suite 100 Los Alamos |
| State: | NM US |
| Postal Code: | 875443023 |
| Phone Number: | 5056619976 |
| Fax Number: | 5056612604 |
| NPI Enumeration Date: | 02/14/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 3201 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |