Organization
ECLIPSESURG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIVIER URAYENEZA MD (PRESIDENT)
(269) 547-0500
Entity
Organization
Contact information
Practice address
160 BLUE JAY LN, REDLANDS, CA 92374-1651
(269) 547-0500
Mailing address
160 BLUE JAY LN, REDLANDS, CA 92374-1651
(269) 547-0500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A133496
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A133496
MEDICAL LICENSE
CA
Enumeration date
10/26/2016
Last updated
10/26/2016
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