Basic Information
| Provider Information | |||||||||
| NPI: | 1861408643 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPECIALTY SURGICAL CENTER OF ARCADIA LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51 N 5TH AVE | ||||||||
| Address2: | STE. 101 | ||||||||
| City: | ARCADIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910063710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264719901 | ||||||||
| FaxNumber: | 6264719020 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 N 5TH AVE | ||||||||
| Address2: | STE. 101 | ||||||||
| City: | ARCADIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910063710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264719901 | ||||||||
| FaxNumber: | 6264719020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | WOLD | ||||||||
| AuthorizedOfficialFirstName: | ERIC | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6264719901 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.