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General NPI Number Information
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NPI Number | 1760859334
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Entity Type | Organization
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Legal Business Name | VISALIA AMBULATORY SURGICAL CENTER LLC
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Dates
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Enumeration Date | 08/29/2015
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 105 E NOBLE AVE
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City | VISALIA
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State | CA
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Zip | 93277-2717
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Country | US
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Telephone | 559-735-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E NOBLE AVE
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City | VISALIA
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State | CA
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Zip | 93277-2717
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Country | US
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Telephone | 559-735-0500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KUSAI AZIZ
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Credential | M.D.
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Telephone | 559-735-0500
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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 | A97987
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License Number State | CA
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