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General NPI Number Information
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NPI Number | 1568749877
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Entity Type | Organization
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Legal Business Name | CENTRAL OUTPATIENT SURGERY CENTER.INC
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 11760 CENTRAL AVE SUITE 204
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City | CHINO
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State | CA
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Zip | 91710-1900
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Country | US
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Telephone | 909-203-4893
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Fax | 909-203-4895
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Provider Business Mailing Address
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Address Line | 11760 CENTRAL AVE SUITE 204
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City | CHINO
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State | CA
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Zip | 91710-1900
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Country | US
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Telephone | 909-203-4893
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Fax | 909-203-4895
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. THOMAS T LEE
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Credential | M.D.
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Telephone | 909-203-4893
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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 |
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