Healthcare Provider Details
I. General information
NPI: 1588895155
Provider Name (Legal Business Name): SPECIALTY SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
197 W VIA LOLA #22
PALM SPRINGS CA
92262-4384
US
IV. Provider business mailing address
197 W VIA LOLA #22
PALM SPRINGS CA
92262-4384
US
V. Phone/Fax
- Phone: 760-673-7267
- Fax:
- Phone:
- Fax:
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 | |
VIII. Authorized Official
Name: DR.
DAVID
MORROW
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 760-673-7267