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Organization
BROCKTON ENDOSCOPY SURGERY CENTER LP
Active
Organization
BROCKTON ENDOSCOPY SURGERY CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINOD MISHRA M.D. (MEDICAL DIRECTOR)
(951) 788-4400
Entity
Organization
Contact information
Practice address
6958 BROCKTON AVE, SUITE 100, RIVERSIDE, CA 92506-3829
(951) 788-4400
Mailing address
6958 BROCKTON AVE, SUITE 100, RIVERSIDE, CA 92506-3829
(951) 788-4400
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Enumeration date
05/03/2007
Last updated
10/07/2015
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