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General NPI Number Information
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NPI Number | 1932285871
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Entity Type | Organization
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Legal Business Name | WASHINGTON OUTPATIENT SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 2299 MOWRY AVENUE 1ST FLOOR
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-791-5374
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Fax |
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Provider Business Mailing Address
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Address Line | 2299 MOWRY AVENUE 1ST FLOOR
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-791-5374
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR OF NURSING
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Name | MR. TREVIN HUNT
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Credential | R.N.
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Telephone | 510-791-5374
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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 | 140000466
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License Number State | CA
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