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General NPI Number Information
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NPI Number | 1407619778
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Entity Type | Organization
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Legal Business Name | POINT WEST SURGERY CENTER
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 1525 RESPONSE RD
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City | SACRAMENTO
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State | CA
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Zip | 95815-4801
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Country | US
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Telephone | 916-492-1828
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Fax |
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Provider Business Mailing Address
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Address Line | 2805 J ST STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95816-4307
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Country | US
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Telephone | 916-492-1828
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Fax | 916-492-1834
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL J FAZIO
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Credential | MD
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Telephone | 916-492-1828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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