Healthcare Provider Details

I. General information

NPI: 1518592021
Provider Name (Legal Business Name): FIRST SURGERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31625 DE PORTOLA RD STE 102
TEMECULA CA
92592-2770
US

IV. Provider business mailing address

31625 DE PORTOLA RD STE 102
TEMECULA CA
92592-2770
US

V. Phone/Fax

Practice location:
  • Phone: 951-501-4251
  • Fax:
Mailing address:
  • Phone: 951-501-4251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: INDRANEEL CHAKRABARTY
Title or Position: PRESIDENT
Credential: MD
Phone: 951-501-4251