=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437185063
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLIANCE SURGERY CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2525 EYE ST
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-2004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-327-5412
-----------------------------------------------------
Fax | 661-327-5412
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12626 BELLFLOWER BLVD
-----------------------------------------------------
City | DOWNEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90242-4802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-446-2229
-----------------------------------------------------
Fax | 562-446-2229
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS OFFICE
-----------------------------------------------------
Name | MS. JUDY HOPKINS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 562-446-2229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------