Healthcare Provider Details

I. General information

NPI: 1275802407
Provider Name (Legal Business Name): VALENCIA AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25775 MCBEAN PKWY STE 108
VALENCIA CA
91355-3702
US

IV. Provider business mailing address

8391 BEVERLY BLVD STE 194
LOS ANGELES CA
90048-2633
US

V. Phone/Fax

Practice location:
  • Phone: 310-230-5741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERTO MACATANGAY
Title or Position: MANAGER
Credential:
Phone: 310-230-5741