Healthcare Provider Details

I. General information

NPI: 1124658083
Provider Name (Legal Business Name): MERIDIAN SURGERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 01/20/2020
Certification Date: 01/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N WIGET LN STE 140
WALNUT CREEK CA
94598-5917
US

IV. Provider business mailing address

21C ORINDA WAY STE 149
ORINDA CA
94563-2534
US

V. Phone/Fax

Practice location:
  • Phone: 916-267-4098
  • Fax:
Mailing address:
  • Phone: 916-267-4098
  • 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: NEGAR SHEIBANI
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 916-267-4098