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General NPI Number Information
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NPI Number | 1629249172
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Entity Type | Organization
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Legal Business Name | NORTH STATE SURGERY CENTERS LP
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2184 COURT ST
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City | REDDING
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State | CA
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Zip | 96001-2530
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Country | US
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Telephone | 530-246-4444
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Fax | 530-246-4445
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Provider Business Mailing Address
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Address Line | 2184 COURT ST
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City | REDDING
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State | CA
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Zip | 96001-2530
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Country | US
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Telephone | 530-246-4444
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Fax | 530-246-4445
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | ERIC BOON
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Credential |
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Telephone | 480-567-0269
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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 | 230000328
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License Number State | CA
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