# SOUTHERN CALIFORNIA MINIMAL INVASIVE ENDOSCOPY INC

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

## Provider details

- **NPI number:** 1518975622
- **Authorized official:** GERGIS RAID GHOBRIAL M.D. (PRESIDENT)
- **Authorized official phone:** (562) 426-0147

## Contact information

- **Practice address:** 2650 ELM AVE, SUITE 318, LONG BEACH, CA 90806-1651
- **Practice address phone:** (562) 426-0147
- **Practice address fax:** (888) 206-5318
- **Mailing address:** 541 GREEN ACRE DR, FULLERTON, CA 92835-3603
- **Mailing address phone:** (562) 426-0147
- **Mailing address fax:** (888) 206-5318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A533370 | CA | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 02/22/2013