1679534614 NPI number — COURTYARD SURGERY PAVILION, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679534614 NPI number — COURTYARD SURGERY PAVILION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COURTYARD SURGERY PAVILION, INC
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:
6
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:
1679534614
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 N AKERS ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
VISALIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93291-5121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-733-4399
Provider Business Mailing Address Fax Number:
559-733-1758

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 N AKERS ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
VISALIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93291-5121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-733-4399
Provider Business Practice Location Address Fax Number:
559-733-1758
Provider Enumeration Date:
03/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FEIL
Authorized Official First Name:
STAN
Authorized Official Middle Name:
HARRISON
Authorized Official Title or Position:
PRESIDENT/MEDICAL DIRECTOR
Authorized Official Telephone Number:
559-733-4399

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  550000162 , 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: 05C0001753 . This is a "CMS NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: FNP 33532 . This is a "FICTITIOUS NAME PERMIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZH5408Z . This is a "TRICARE PROVIDER#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 550000162 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CLN 1607 . This is a "PHARMACY CLINIC PERMIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942205240 . This is a "STAN H. FEIL, M.D. (NPI)" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZZZH5408Z . This is a "BLUE SHIELD PROVIDER ID#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: BL018923 . This is a "BUSINESS TAX CERTIFICATE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 2732566 . This is a "ARTICLES OF INCORPORATION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P00334549 . This is a "MEDICARE RAILROAD #" identifier . This identifiers is of the category "OTHER".
  • Identifier: SUR01753F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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