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Organization

PASADENA ENDOSCOPY CENTER INC

Active
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Organization

PASADENA ENDOSCOPY CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD NICKOWITZ MD (PRESIDENT/MEDICAL DIRECTOR)
(626) 793-9900
Entity
Organization

Contact information

Practice address
55 W VALLEY ST, PASADENA, CA 91105-2015
(626) 793-9900
(626) 793-9944
Mailing address
55 W VALLEY ST, PASADENA, CA 91105-2015
(626) 793-9900
(626) 793-9944

Taxonomy

Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
930000974
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
490005486
RAILROAD MEDICARE PIN
CA
05
SUR01537F
CA
Enumeration date
09/20/2006
Last updated
03/11/2014
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