Healthcare Provider Details

I. General information

NPI: 1528937174
Provider Name (Legal Business Name): CDMS SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BELLEFONTAINE ST STE 206
PASADENA CA
91105-3132
US

IV. Provider business mailing address

50 BELLEFONTAINE ST STE 206
PASADENA CA
91105-3132
US

V. Phone/Fax

Practice location:
  • Phone: 626-654-3376
  • Fax:
Mailing address:
  • Phone: 626-654-3376
  • 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: TAREN CESSNA
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 805-312-0667