Healthcare Provider Details

I. General information

NPI: 1811004575
Provider Name (Legal Business Name): REGIONAL VALLEY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 WEST AVE J
LANCASTER CA
93534-2700
US

IV. Provider business mailing address

1720 WEST AVE J
LANCASTER CA
93534-2700
US

V. Phone/Fax

Practice location:
  • Phone: 661-952-1100
  • Fax: 661-952-1116
Mailing address:
  • Phone: 661-952-1100
  • Fax: 661-952-1116

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: KAREN LYNN DOFFING
Title or Position: BUSINESS MANAGER
Credential: CCSP
Phone: 661-952-1100