Healthcare Provider Details

I. General information

NPI: 1386056760
Provider Name (Legal Business Name): CITY SURGICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 POST ST SUITE 108
SAN FRANCISCO CA
94115-3441
US

IV. Provider business mailing address

2299 POST ST SUITE 108
SAN FRANCISCO CA
94115-3441
US

V. Phone/Fax

Practice location:
  • Phone: 415-923-3770
  • Fax: 415-923-3779
Mailing address:
  • Phone: 415-923-3770
  • Fax: 415-923-3779

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: DR. LEONARD GORDON
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 415-923-0992