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General NPI Number Information
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NPI Number | 1114043858
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Entity Type | Organization
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Legal Business Name | AZUSA SURGERY CENTER LLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 830 S. CITRUS AVE SUITE 101
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City | AZUSA
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State | CA
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Zip | 91702
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Country | US
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Telephone | 626-543-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 10565 CIVIC CENTER DR STE 250
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3854
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Country | US
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Telephone | 626-543-1560
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Fax | 626-974-6900
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Authorized Official
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Title or Position | CEO
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Name | DR. CLAYTON A VARGA
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Credential | M.D
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Telephone | 626-696-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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