Organization
RESERVOIR PHYSICIANS SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRIS F KOENIG (CHIEF EXECUTIVE OFFICER)
(619) 229-3172
Entity
Organization
Contact information
Practice address
6719 ALVARADO RD, SUITE 100, SAN DIEGO, CA 92120-5270
(619) 229-3100
Mailing address
6719 ALVARADO RD, SUITE 100, SAN DIEGO, CA 92120-5270
(619) 229-3100
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2009
Last updated
07/14/2009
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