Healthcare Provider Details
I. General information
NPI: 1477792828
Provider Name (Legal Business Name): PRECISION SURGICENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2009
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
39180 FARWELL DR SUITE 100
FREMONT CA
94538-1052
US
IV. Provider business mailing address
39180 FARWELL DR SUITE 100
FREMONT CA
94538-1052
US
V. Phone/Fax
- Phone: 510-494-0800
- Fax: 510-494-0804
- Phone: 510-494-0800
- Fax: 510-494-0804
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
BASIL
R
BESH
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 510-494-0800