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General NPI Number Information
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NPI Number | 1629753413
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Entity Type | Organization
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Legal Business Name | EMPIRE SURGICAL CENTER
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 4480 MILLS CIR
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City | ONTARIO
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State | CA
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Zip | 91764-5206
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Country | US
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Telephone | 909-515-7174
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Fax |
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Provider Business Mailing Address
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Address Line | 4480 MILLS CIR
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City | ONTARIO
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State | CA
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Zip | 91764-5206
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Country | US
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Telephone | 909-515-7174
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDY NAVID
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Credential |
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Telephone | 909-515-7174
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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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