Healthcare Provider Details
I. General information
NPI: 1790936847
Provider Name (Legal Business Name): RSC SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2008
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 PARK PLACE SUITE 200
SAN RAMON CA
94583
US
IV. Provider business mailing address
100 PARK PLACE SUITE 200
SAN RAMON CA
94583
US
V. Phone/Fax
- Phone: 925-973-1800
- Fax: 925-973-5064
- Phone: 925-973-1800
- Fax: 925-973-5064
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIRSTIN
RUNA
Title or Position: EXECUTIVE VICE PRESIDENT OF OPERATI
Credential:
Phone: 720-810-0707