Healthcare Provider Details

I. General information

NPI: 1356572465
Provider Name (Legal Business Name): ORCHARD CREEK SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 SAMARITAN DR
SAN JOSE CA
95124-3907
US

IV. Provider business mailing address

2420 SAMARITAN DR
SAN JOSE CA
95124-3907
US

V. Phone/Fax

Practice location:
  • Phone: 408-369-5600
  • Fax: 408-369-5625
Mailing address:
  • Phone: 408-369-5600
  • Fax: 408-369-5625

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. GREG MORGANROTH
Title or Position: CEO
Credential:
Phone: 650-969-5600