| Organization Name: | PACIFIC ENDOSCOPY LLC |
| NPI Number: | 1316291867 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID W. HOLST (PRESIDENT BOARD OF MANAGERS) |
| Mailing Address: | 3351 El Camino Real Ste 220 Atherton |
| State: | CA US |
| Postal Code: | 940273811 |
| Phone Number: | 6503653700 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2012 |
| NPI Last Update Date: | 04/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |