Healthcare Provider Details

I. General information

NPI: 1780287276
Provider Name (Legal Business Name): ST. GEORGE SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E NOBLE AVE
VISALIA CA
93277-2700
US

IV. Provider business mailing address

111 E NOBLE AVE
VISALIA CA
93277-2700
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-6500
  • Fax: 559-627-6501
Mailing address:
  • Phone: 559-627-6500
  • Fax: 559-627-6501

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: DR. HANY NASR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 559-627-6500