1932106358 NPI number — THE CENTER FOR AMBULATORY SURGICAL TREATMENT, LP

Table of content: (NPI 1932106358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932106358 NPI number — THE CENTER FOR AMBULATORY SURGICAL TREATMENT, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CENTER FOR AMBULATORY SURGICAL TREATMENT, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932106358
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1090 GLENDON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90024-2908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-209-6500
Provider Business Mailing Address Fax Number:
310-209-6225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1090 GLENDON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90024-2908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-209-6500
Provider Business Practice Location Address Fax Number:
310-209-6225
Provider Enumeration Date:
06/30/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
OFFICER, AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
972-763-3859

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  930000985 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00114687 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: AS1581 . This is a "BLUE CROSS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".