# RESERVOIR PHYSICIANS SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427295658
- **Authorized official:** MR. HARRIS F KOENIG (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (619) 229-3172

## Contact information

- **Practice address:** 6719 ALVARADO RD, SUITE 100, SAN DIEGO, CA 92120-5270
- **Practice address phone:** (619) 229-3100
- **Mailing address:** 6719 ALVARADO RD, SUITE 100, SAN DIEGO, CA 92120-5270
- **Mailing address phone:** (619) 229-3100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/09/2009
- **Last updated:** 07/14/2009