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General NPI Number Information
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NPI Number | 1790005304
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Entity Type | Organization
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Legal Business Name | SOAR SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 1849 BAYSHORE HWY
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City | BURLINGAME
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State | CA
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Zip | 94010-1215
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Country | US
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Telephone | 650-539-6000
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Fax | 650-539-6001
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Provider Business Mailing Address
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Address Line | 1849 BAYSHORE HWY
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City | BURLINGAME
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State | CA
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Zip | 94010-1215
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Country | US
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Telephone | 650-539-6000
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Fax | 650-539-6001
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Authorized Official
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Title or Position | GENERAL MANAGING PARTNER
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Name | DR. MICHAEL F. DILLINGHAM
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Credential | MD
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Telephone | 650-539-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) 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 | 213E00000X
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Taxonomy Name | Podiatrist
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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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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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