MEDICARE: SACRAMENTO VALLEY SURGERY CENTER LLC

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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1548605082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRAMENTO VALLEY SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	1970 LAKE BLVD
Second Line	:	SUITE 2
City	:	DAVIS
State	:	CA
Zip	:	95616-5663
Country	:	US
Telephone Number	:	530-756-1152
Fax Number	:	530-756-1153

Provider Business Practice Location Address
First Line	:	1970 LAKE BLVD
Second Line	:	SUITE 2
City	:	DAVIS
State	:	CA
Zip	:	95616-5663
Country	:	US
Telephone Number	:	530-756-1152
Fax Number	:	530-756-1153

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. LAWRENCE R CATE
Credential	:
Telephone Number	:	916-473-7602

Provider Enumeration Date	:	05/09/2013
Last Update Date	:	05/09/2013

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