Healthcare Provider Details

I. General information

NPI: 1780683078
Provider Name (Legal Business Name): COURT STREET SURGERY CENTER, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2439 SONOMA ST
REDDING CA
96001-3026
US

IV. Provider business mailing address

2439 SONOMA ST
REDDING CA
96001-3026
US

V. Phone/Fax

Practice location:
  • Phone: 530-241-1303
  • Fax: 530-241-0200
Mailing address:
  • Phone: 530-241-1303
  • Fax: 530-241-0200

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: PATRICIA JOY KUROSAKA
Title or Position: REGIONAL DIRECTOR
Credential: RN
Phone: 530-246-4444