Healthcare Provider Details

I. General information

NPI: 1982409801
Provider Name (Legal Business Name): CENTER FOR SURGICAL EXCELLENCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18002 WIKA RD
APPLE VALLEY CA
92307-2125
US

IV. Provider business mailing address

18002 WIKA RD
APPLE VALLEY CA
92307-2125
US

V. Phone/Fax

Practice location:
  • Phone: 760-946-2243
  • Fax:
Mailing address:
  • Phone: 760-946-2243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHAMMAD REZA AHMADINIA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 760-946-2243