MEDICARE: DAVIS SURGERY CENTER, LP

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
1	261QA1903X	Ambulatory Surgical Clinic/Center	030001792	CA

General Provider Information

NPI Number	:	1205894466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVIS SURGERY CENTER, LP

Provider Business Mailing Address
First Line	:	20 BURTON HILLS BLVD.
Second Line	:	SUITE 500 ATTN: L&C
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6176
Country	:	US
Telephone Number	:	615-240-3820
Fax Number	:	615-234-1720

Provider Business Practice Location Address
First Line	:	2120 COWELL BLVD
Second Line	:	SUITE 142
City	:	DAVIS
State	:	CA
Zip	:	95618-7840
Country	:	US
Telephone Number	:	530-750-7766
Fax Number	:	530-750-7767

Authorized Official
Title or Position	:	PRESIDENT OF LP
Name	:	MR. PHILLIP A CLENDENIN
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/07/2023

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