Organization
ADVANCED ENDOSCOPY AND PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID HOLST (PRESIDENT, BOARD OF MANAGERS)
61534566900
Entity
Organization
Contact information
Practice address
1753 W AVENUE J, STE A, LANCASTER, CA 93534-9823
(661) 206-0555
Mailing address
1753 W AVENUE J, STE A, LANCASTER, CA 93534-9823
(661) 206-0555
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2012
Last updated
04/05/2016
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