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General NPI Number Information
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NPI Number | 1245371327
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Entity Type | Organization
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Legal Business Name | PARADISE SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 02/21/2014
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Provider Practice Location Address
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Address Line | 6480 PENTZ RD SUITE A
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City | PARADISE
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State | CA
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Zip | 95969-3672
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Country | US
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Telephone | 530-877-4983
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Fax | 530-877-8621
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Provider Business Mailing Address
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Address Line | 6480 PENTZ RD SUITE A
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City | PARADISE
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State | CA
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Zip | 95969-3672
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Country | US
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Telephone | 530-877-4983
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Fax | 530-877-8621
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Authorized Official
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Title or Position | PARTNER
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Name | DR. LYLE B HUNT
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Credential | M.D.
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Telephone | 530-877-4986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G544660
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License Number State | CA
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