Organization
MIRAGE ENDOSCOPY CENTER, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN BRODY (CEO/ADMINISTRATOR)
(760) 837-9210
Entity
Organization
Contact information
Practice address
70017 HIGHWAY 111 STE 2, RANCHO MIRAGE, CA 92270-2999
(760) 837-9210
(760) 837-9232
Mailing address
70017 HIGHWAY 111 STE 2, RANCHO MIRAGE, CA 92270-2999
(760) 837-9210
(760) 837-9232
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
250000789
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR01594F
—
CA
Enumeration date
06/08/2005
Last updated
07/11/2025
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