Healthcare Provider Details

I. General information

NPI: 1912606054
Provider Name (Legal Business Name): WCEI SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11901 BOLTHOUSE DR
BAKERSFIELD CA
93311-8455
US

IV. Provider business mailing address

11901 BOLTHOUSE DR
BAKERSFIELD CA
93311-8455
US

V. Phone/Fax

Practice location:
  • Phone: 661-393-3231
  • Fax:
Mailing address:
  • Phone: 661-393-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JULIA CASTILLO
Title or Position: ADMIN
Credential:
Phone: 661-393-3231