Healthcare Provider Details

I. General information

NPI: 1306369566
Provider Name (Legal Business Name): NOVA SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8331 WESTMINSTER BLVD STE B
WESTMINSTER CA
92683
US

IV. Provider business mailing address

8331 WESTMINSTER BLVD STE B
WESTMINSTER CA
92683-3398
US

V. Phone/Fax

Practice location:
  • Phone: 714-248-9477
  • Fax: 714-908-8186
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ARIANE WINANS
Title or Position: MANAGING PARTNER
Credential:
Phone: 714-248-9477