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General NPI Number Information
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NPI Number | 1245285857
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Entity Type | Organization
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Legal Business Name | AMBULATORY SURGERY CENTER OF EAGER STEVEN E MD GEN PTR
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 08/19/2010
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Provider Practice Location Address
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Address Line | 2388 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204-5506
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Country | US
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Telephone | 209-944-9100
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Fax | 209-944-4509
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Provider Business Mailing Address
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Address Line | 2388 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204-5506
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Country | US
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Telephone | 209-944-9100
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Fax | 209-944-4509
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. NICKI CRAIG
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Credential |
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Telephone | 209-944-9100
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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 | 030000758
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License Number State | CA
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