Healthcare Provider Details

I. General information

NPI: 1265257612
Provider Name (Legal Business Name): UNITED SURGERY CENTER LONG BEACH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3849 ATLANTIC AVENUE
LONG BEACH CA
90807
US

IV. Provider business mailing address

25150 HANCOCK AVE STE 208
MURRIETA CA
92562-5989
US

V. Phone/Fax

Practice location:
  • Phone: 951-764-9396
  • Fax:
Mailing address:
  • Phone: 951-764-9396
  • Fax:

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: KEN JONES
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 951-764-9396