Healthcare Provider Details

I. General information

NPI: 1962556076
Provider Name (Legal Business Name): AK SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13690 E 14TH ST
SAN LEANDRO CA
94578-2582
US

IV. Provider business mailing address

PO BOX 823
DANVILLE CA
94526-0823
US

V. Phone/Fax

Practice location:
  • Phone: 510-297-0560
  • Fax:
Mailing address:
  • Phone: 510-297-0560
  • 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: ANDREW STEIN
Title or Position: OWNER
Credential:
Phone: 510-297-0560