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General NPI Number Information
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NPI Number | 1174258602
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Entity Type | Organization
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Legal Business Name | APOLLO SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 43944 15TH STREET W SUITE 101
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City | LANCASTER
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State | CA
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Zip | 93534
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Country | US
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Telephone | 661-579-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 43944 15TH STREET W SUITE 101
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City | LANCASTER
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State | CA
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Zip | 93534
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Country | US
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Telephone | 661-579-4700
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN, GOVERNING BODY
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Name | DR. VIVAIK TYAGI
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Credential | MD
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Telephone | 661-579-4700
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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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