Healthcare Provider Details

I. General information

NPI: 1700842507
Provider Name (Legal Business Name): ARCADIA OUTPATIENT SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 W DUARTE RD
ARCADIA CA
91007-7601
US

IV. Provider business mailing address

614 W DUARTE RD
ARCADIA CA
91007-7601
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-4714
  • Fax:
Mailing address:
  • Phone:
  • 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: MS. SARA GAMM
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 626-445-4714