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General NPI Number Information
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NPI Number | 1992022297
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Entity Type | Organization
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Legal Business Name | MID VALLEY SURGERY CENTER LLC
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 4682 E. ONTARIO MILLS PARKWAY
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City | ONTARIO
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State | CA
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Zip | 91764-5148
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Country | US
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Telephone | 626-696-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 10565 CIVIC CENTER DR STE 250
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3854
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Country | US
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Telephone | 909-204-3540
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Fax | 909-989-3007
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CLAYTON A VARGA
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Credential | M.D
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Telephone | 626-696-1400
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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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