Healthcare Provider Details

I. General information

NPI: 1740393578
Provider Name (Legal Business Name): TEHAMA SURGERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 LIBERTY PKWY
RED BLUFF CA
96080-4350
US

IV. Provider business mailing address

2340 LIBERTY PKWY
RED BLUFF CA
96080-4350
US

V. Phone/Fax

Practice location:
  • Phone: 530-528-8701
  • Fax: 530-528-8712
Mailing address:
  • Phone: 530-528-8701
  • Fax: 530-528-8712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. NORMAN NASISE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 530-528-8701