Basic Information
| Provider Information | |||||||||
| NPI: | 1629231782 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PASADENA ADVANCED SURGERY INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1044 S FAIR OAKS AVE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911052622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6267684422 | ||||||||
| FaxNumber: | 6267684421 | ||||||||
| Practice Location | |||||||||
| Address1: | 1044 S FAIR OAKS AVE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911052622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6267684422 | ||||||||
| FaxNumber: | 6267684421 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2008 | ||||||||
| LastUpdateDate: | 07/08/2008 | ||||||||
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| AuthorizedOfficialLastName: | KWAN | ||||||||
| AuthorizedOfficialFirstName: | VALERIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6267684422 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.