Healthcare Provider Details

I. General information

NPI: 1326362393
Provider Name (Legal Business Name): PHYSICIANS SURGICAL CARE AFFILIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 03/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 LONG BEACH BLVD SUITE 1H
LONG BEACH CA
90807-3907
US

IV. Provider business mailing address

3505 LONG BEACH BLVD SUITE 1H
LONG BEACH CA
90807-3907
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-7600
  • Fax: 562-424-7601
Mailing address:
  • Phone: 562-424-7600
  • Fax: 562-424-7601

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: MR. JOHN P HUFFMAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 562-424-7600