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General NPI Number Information
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NPI Number | 1558417972
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Entity Type | Organization
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Legal Business Name | SIERRA PLASTIC SURGERY CENTER INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 6153 N THESTA
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City | FRESNO
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State | CA
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Zip | 93710-5266
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Country | US
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Telephone | 559-432-5757
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Fax | 559-432-3556
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Provider Business Mailing Address
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Address Line | 6153 N THESTA
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City | FRESNO
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State | CA
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Zip | 93710-5266
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Country | US
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Telephone | 559-432-5757
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Fax | 559-432-3556
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. ALLAN JOHN EROPKIN
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Credential |
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Telephone | 559-432-2757
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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 | 040000310
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License Number State | CA
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