SAN LUIS OBISPO CA ENDOSCOPY ASC LP NPI 1487629986

NPI Information

  • NPI: 1487629986
  • Provider Name: SAN LUIS OBISPO CA ENDOSCOPY ASC LP
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: ENDOSCOPY CENTER OF THE CENTRAL COAST
  • CLIA Number: 05D1043295
  • Address: 77 CASA ST
    SUITE 106
    SAN LUIS OBISPO, CA
    ZIP 93405
  • Phone: (805) 541-1021

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NPI Details

SAN LUIS OBISPO CA ENDOSCOPY ASC LP is an ambulatory surgical clinic center in San Luis Obispo, CA. SAN LUIS OBISPO CA ENDOSCOPY ASC LP NPI is 1487629986. The provider is registered as an organization entity type.
The provider Is Doing Business As Endoscopy Center Of The Central Coast.

The provider's business location address is:

77 CASA ST
SUITE 106
SAN LUIS OBISPO, CA
ZIP 93405-803
Phone: (805) 541-1021
Fax: (805) 541-3142

The provider's authorized official is Jeffrey Snodgrass .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 05D1043295 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Insertion of guide wire with dilation of esophagus using a flexible endoscope (HCPCS:43248)

The enumeration date for this NPI number is 2/20/2006 and was last updated on 6/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical050000424CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1SUR01318FMEDICAIDCALIFORNIA
2P00638978OTHERCALIFORNIARAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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