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General NPI Number Information
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NPI Number | 1831794049
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Entity Type | Organization
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Legal Business Name | CALIFORNIA MEDICAL SURGERY CENTER LLC
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 620 CALIFORNIA BLVD STE M
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2526
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Country | US
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Telephone | 805-548-1070
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Fax | 805-548-1071
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Provider Business Mailing Address
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Address Line | 620 CALIFORNIA BLVD STE M
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2526
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Country | US
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Telephone | 805-548-1070
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIFER FALK
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Credential | RN
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Telephone | 805-548-1070
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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 |
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