Healthcare Provider Details

I. General information

NPI: 1821536343
Provider Name (Legal Business Name): SALUTARIS SURGERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9041 MAGNOLIA AVE STE 301
RIVERSIDE CA
92503-3957
US

IV. Provider business mailing address

9041 MAGNOLIA AVE STE 301
RIVERSIDE CA
92503-3957
US

V. Phone/Fax

Practice location:
  • Phone: 951-359-0500
  • Fax: 951-359-0550
Mailing address:
  • Phone: 951-359-0500
  • Fax: 951-359-0550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA86739
License Number StateCA

VIII. Authorized Official

Name: EDUARDO P MACIAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-359-0500