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General NPI Number Information
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NPI Number | 1699570879
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SURGICAL CENTER, INC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 8283 GROVE AVE STE 207B
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3137
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Country | US
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Telephone | 401-575-0308
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 379
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City | PASADENA
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State | CA
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Zip | 91102-0379
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Country | US
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Telephone | 562-548-7530
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MALWINDER S SINGHA
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Credential | MD
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Telephone | 401-575-0308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #3
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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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