Healthcare Provider Details

I. General information

NPI: 1760581003
Provider Name (Legal Business Name): ANACAPA AMBULATORY SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 N PONDEROSA DR A116
CAMARILLO CA
93010-2398
US

IV. Provider business mailing address

2460 N PONDEROSA DR A116
CAMARILLO CA
93010-2398
US

V. Phone/Fax

Practice location:
  • Phone: 805-484-4226
  • Fax: 805-389-1245
Mailing address:
  • Phone: 805-484-4226
  • Fax: 805-389-1245

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: ROBERT STEPHEN IMPROTA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 805-484-4226