Organization
J C PITTS ENTERPRISES INC
Active
Other names
Ontario Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MONG DO (MEDICAL DIRECTOR/OWNER)
(208) 377-3937
Entity
Organization
Contact information
Practice address
251 SW 19TH STREET, ONTARIO, OR 97914-1972
(541) 889-3198
(208) 377-9455
Mailing address
251 SW 19TH STREET, ONTARIO, OR 97914-1972
(541) 889-3198
(208) 377-9455
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071506ASC
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010019705
BLUE SHIELD
ID
05
—
003419300
—
ID
01
—
100783000
BLUE CROSS
OR
01
—
100783000
BLUE CROSS OREGON
—
05
—
135876
—
OR
01
—
BMUY9
BLUE CROSS
ID
01
—
P051001
PACIFIC SOURCE
—
Enumeration date
11/17/2006
Last updated
03/04/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us