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General NPI Number Information
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NPI Number | 1730514027
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Entity Type | Organization
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Legal Business Name | KY ADVANCED SURGICAL CENTER INC
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 3796 N FRESNO ST 103
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City | FRESNO
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State | CA
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Zip | 93726-5500
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Country | US
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Telephone | 559-221-9905
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Fax | 559-221-9908
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Provider Business Mailing Address
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Address Line | 3796 N FRESNO ST STE 103
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City | FRESNO
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State | CA
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Zip | 93726-5500
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Country | US
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Telephone | 559-221-9905
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Fax | 559-221-9908
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Authorized Official
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Title or Position | BILLER
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Name | SARAH BARELA
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Credential |
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Telephone | 559-435-1757
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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 | 20A10743
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License Number State | CA
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