Healthcare Provider Details

I. General information

NPI: 1306694633
Provider Name (Legal Business Name): DIABLO VIEW SURGICAL SERVICES. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 ARNOLD DR
MARTINEZ CA
94553-4219
US

IV. Provider business mailing address

1815 ARNOLD DR
MARTINEZ CA
94553-4219
US

V. Phone/Fax

Practice location:
  • Phone: 925-705-4900
  • Fax:
Mailing address:
  • Phone: 925-705-4900
  • 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: MR. PAUL SCHRUPP
Title or Position: MANAGER
Credential:
Phone: 916-768-2890