Healthcare Provider Details

I. General information

NPI: 1417994831
Provider Name (Legal Business Name): CATALINA SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7508 N LA CHOLLA BLVD
TUCSON AZ
85741-2307
US

IV. Provider business mailing address

7508 N LA CHOLLA BLVD
TUCSON AZ
85741-2307
US

V. Phone/Fax

Practice location:
  • Phone: 520-547-7450
  • Fax: 520-547-7455
Mailing address:
  • Phone: 520-547-7450
  • Fax: 520-547-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberOSC3940
License Number StateAZ

VIII. Authorized Official

Name: AJAY SANAN
Title or Position: MEMBER
Credential: MD
Phone: 520-229-1554