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General NPI Number Information
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NPI Number | 1316190077
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Entity Type | Organization
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Legal Business Name | CERRITOS SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 16543 CARMENITA AVENUE
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City | CERRITOS
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State | CA
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Zip | 90703-2218
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Country | US
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Telephone | 562-219-7251
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Fax | 562-219-7252
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Provider Business Mailing Address
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Address Line | 16543 CARMENITA AVENUE
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City | CERRITOS
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State | CA
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Zip | 90703-2218
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Country | US
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Telephone | 562-219-7251
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Fax | 562-219-7290
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Authorized Official
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Title or Position | ADMIN
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Name | JAQUI V JAIME
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Credential |
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Telephone | 562-219-7251
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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 | CA
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