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NPI Code Detail

MEDICARE: QUALITY CARE SURGERY CENTER, LLC

MEDICARE: QUALITY CARE SURGERY CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1093156937
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUALITY CARE SURGERY CENTER, LLC
Provider Business Mailing Address
First Line : 5700 SAN FERNANDO RD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2104
Country : US
Telephone Number : 818-637-7786
Fax Number :
Provider Business Practice Location Address
First Line : 5700 SAN FERNANDO RD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2104
Country : US
Telephone Number : 818-637-7766
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. VENESA JAMI ANGULO
Credential : RN, BSN, MBA
Telephone Number : 818-637-7786
Provider Enumeration Date : 07/08/2013
Last Update Date : 07/08/2013

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Directions to “QUALITY CARE SURGERY CENTER, LLC ” Practice Location

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