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General NPI Number Information
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NPI Number | 1801230719
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Entity Type | Organization
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Legal Business Name | CAMARILLO SURGICAL CENTER ASSOCIATES INC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 2460 N PONDEROSA DR SUITE A-116
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City | CAMARILLO
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State | CA
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Zip | 93010-2398
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Country | US
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Telephone | 805-484-4226
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Fax |
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Provider Business Mailing Address
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Address Line | 2460 N PONDEROSA DR SUITE A-116
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City | CAMARILLO
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State | CA
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Zip | 93010-2398
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Country | US
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Telephone | 805-484-4226
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL G KOLDER
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Credential | MD
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Telephone | 805-484-4226
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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 | A115790
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License Number State | CA
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