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General NPI Number Information
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NPI Number | 1801822739
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Entity Type | Organization
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Legal Business Name | SYLVAN SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 2336 SYLVAN AVE SUITE B
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City | MODESTO
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State | CA
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Zip | 95355-9211
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Country | US
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Telephone | 209-338-0393
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Fax | 209-338-0398
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Provider Business Mailing Address
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Address Line | 2336 SYLVAN AVE STE B
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City | MODESTO
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State | CA
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Zip | 95355-9211
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Country | US
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Telephone | 209-338-0393
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Fax | 209-338-0398
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Authorized Official
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Title or Position | MARKET PRESIDENT
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Name | ERIC BOON
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Credential |
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Telephone | 408-567-0269
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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 | 550000147
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License Number State | CA
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