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General NPI Number Information
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NPI Number | 1629111430
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Entity Type | Organization
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Legal Business Name | MONTEREY PARK OUTPATIENT SURGERY CENTER INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 201 W GARVEY AVE STE. 201
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City | MONTEREY PARK
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State | CA
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Zip | 91754-7418
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Country | US
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Telephone | 626-280-3393
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Fax | 626-280-2931
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Provider Business Mailing Address
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Address Line | 201 W GARVEY AVE STE. 201
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City | MONTEREY PARK
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State | CA
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Zip | 91754-7418
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Country | US
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Telephone | 626-280-3393
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Fax | 626-280-2931
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID K QUON
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Credential |
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Telephone | 626-280-3393
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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 | 930000988
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License Number State | CA
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