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General NPI Number Information
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NPI Number | 1588191167
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Entity Type | Organization
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Legal Business Name | HIGH DESERT AMBULATORY SURGICAL CENTER INC
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 05/15/2017
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Provider Practice Location Address
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Address Line | 12241 INDUSTRIAL BLVD STE 101
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City | VICTORVILLE
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State | CA
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Zip | 92395-7795
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Country | US
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Telephone | 760-881-3933
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Fax | 949-863-8505
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Provider Business Mailing Address
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Address Line | 18400 US HIGHWAY 18 STE A
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2306
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Country | US
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Telephone | 760-242-3939
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Fax | 949-863-8505
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | DR. PARASTOU ILBEIGI
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Credential | DC
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Telephone | 760-515-6260
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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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