Healthcare Provider Details

I. General information

NPI: 1194057422
Provider Name (Legal Business Name): DANIEL BURNHAM COURT SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#1 DANIEL BURNHAM COURT SUITE 368C
SAN FRANCISCO CA
94109-5455
US

IV. Provider business mailing address

#1 DANIEL BURNHAM COURT SUITE 368C
SAN FRANCISCO CA
94109-5455
US

V. Phone/Fax

Practice location:
  • Phone: 415-441-1888
  • Fax: 415-441-9587
Mailing address:
  • Phone: 415-441-1888
  • Fax: 415-441-9587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number200918410322
License Number StateCA

VIII. Authorized Official

Name: DR. ALBERT WEI CHOW
Title or Position: OWNER/PRESIDENT
Credential: M.C.
Phone: 415-441-1888