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General NPI Number Information
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NPI Number | 1821536954
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Entity Type | Organization
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Legal Business Name | WEBSTER SURGERY CENTER, LP
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 20998 REDWOOD DR
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City | CASTRO VALLEY
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State | CA
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Zip | 94546
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Country | US
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Telephone | 510-576-8525
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Fax | 510-576-0248
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Provider Business Mailing Address
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Address Line | 80 GRAND AVE SUITE 250
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City | OAKLAND
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State | CA
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Zip | 94612-3725
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Country | US
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Telephone | 510-451-1875
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Fax | 510-839-9588
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. GLEN K. LAU
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Credential | M.D.
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Telephone | 510-451-1875
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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 |
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License Number State | CA
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