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General NPI Number Information
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NPI Number | 1831371749
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Entity Type | Organization
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Legal Business Name | PRISTINE SURGERY CENTER, INC
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 7085 N MAPLE AVE
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City | FRESNO
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State | CA
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Zip | 93720-8011
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Country | US
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Telephone | 559-431-8888
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Fax | 559-447-8400
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Provider Business Mailing Address
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Address Line | 7685 N KAVANAGH AVE
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City | FRESNO
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State | CA
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Zip | 93711-0362
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Country | US
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Telephone | 559-431-8888
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Fax | 559-447-8400
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. PINKY PATTAR
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Credential |
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Telephone | 559-431-8888
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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 | 261QA1903X
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License Number State | CA
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