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General NPI Number Information
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NPI Number | 1841045655
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Entity Type | Organization
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Legal Business Name | COMMUNITY SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 782 MEDICAL CENTER DR E # 112
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City | CLOVIS
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State | CA
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Zip | 93611-6889
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Country | US
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Telephone | 559-324-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 789 N MEDICAL CENTER DR W
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City | CLOVIS
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State | CA
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Zip | 93611-6878
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Country | US
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Telephone | 559-324-4001
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JONATHAN MILLER
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Credential |
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Telephone | 559-324-4720
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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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