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NPI Code Detail

MEDICARE: SOUTHWEST OUTPATIENT SURGERY CENTER, INC

MEDICARE: SOUTHWEST OUTPATIENT SURGERY CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/CenterCA

General Provider Information

NPI Number : 1053512624
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST OUTPATIENT SURGERY CENTER, INC
Provider Business Mailing Address
First Line : 1601 MILL ROCK WAY
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-1315
Country : US
Telephone Number : 661-833-0101
Fax Number : 661-397-9547
Provider Business Practice Location Address
First Line : 1601 MILL ROCK WAY
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-1315
Country : US
Telephone Number : 661-833-0101
Fax Number : 661-397-9547
Authorized Official
Title or Position : OWNER
Name : ANTHONY CHING
Credential : DDS
Telephone Number : 661-833-0101
Provider Enumeration Date : 05/30/2007
Last Update Date : 08/22/2020

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