Healthcare Provider Details

I. General information

NPI: 1437258001
Provider Name (Legal Business Name): PACIFIC HEIGHTS SURGERY CENTER OF SAN FRANCISCO, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 SAN FRANCISCO ST 2ND FLOOR
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

11999 SAN VICENTE BLVD STE 440
LOS ANGELES CA
90049
US

V. Phone/Fax

Practice location:
  • Phone: 888-282-7472
  • Fax:
Mailing address:
  • Phone: 310-440-3131
  • Fax:

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: MR. DAVE O'DELL
Title or Position: PARTNER
Credential:
Phone: 888-282-7472