Healthcare Provider Details

I. General information

NPI: 1396050829
Provider Name (Legal Business Name): REDWOOD SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20998 REDWOOD RD
CASTRO VALLEY CA
94546-5918
US

IV. Provider business mailing address

20998 REDWOOD RD
CASTRO VALLEY CA
94546-5918
US

V. Phone/Fax

Practice location:
  • Phone: 925-600-1900
  • Fax: 925-600-1908
Mailing address:
  • Phone: 925-600-1900
  • Fax: 925-600-1908

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. DOUGLAS ABELES
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 925-600-1900