Organization
SOUTHERN CALIFORNIA MINIMAL INVASIVE ENDOSCOPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERGIS RAID GHOBRIAL M.D. (PRESIDENT)
(562) 426-0147
Entity
Organization
Contact information
Practice address
2650 ELM AVE, SUITE 318, LONG BEACH, CA 90806-1651
(562) 426-0147
(888) 206-5318
Mailing address
541 GREEN ACRE DR, FULLERTON, CA 92835-3603
(562) 426-0147
(888) 206-5318
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A533370
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A533370
—
CA
Enumeration date
08/04/2006
Last updated
02/22/2013
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