JEDI VENTURES LLC NPI 1881792596

NPI Information

NPI: 1881792596
Provider Name: JEDI VENTURES, LLC

Doing Business As: SACRAMENTO EYE SURGICENTER

Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

Address:
3150 J ST
SACRAMENTO, CA
ZIP 95816
Phone: (916) 444-7052
Get Directions

JEDI VENTURES, LLC is an ophthalmologic surgery clinic center in Sacramento, CA. JEDI VENTURES, LLC NPI is 1881792596. The provider is registered as an organization entity type.
The provider Is Doing Business As Sacramento Eye Surgicenter.

The provider's business location address is:

3150 J ST
SACRAMENTO, CA
ZIP 95816-403
Phone: (916) 444-7052
Fax: (916) 446-1145

The provider's authorized official is Keith Liang .
The authorized official title is Medical Director and has the following contact phone number (916) 444-7052.

The CLIA number assigned to this NPI record is 05D0936964 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 1/9/2008.

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
1	261QS0132X	Clinic/Center	Ophthalmologic Surgery		CALIFORNIA	Yes

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
1	SUR51062H	MEDICAID	CALIFORNIA
2	ZZZ15508Z	MEDICARE PIN

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: 5/5/2024

NPI Synchronization or Removal

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