Basic Information
| Provider Information | |||||||||
| NPI: | 1881603256 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARTHROSCOPIC SURGERY ASSOCIATES CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27708 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937297708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594381245 | ||||||||
| FaxNumber: | 5592612968 | ||||||||
| Practice Location | |||||||||
| Address1: | 7255 N CEDAR AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937203831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594381245 | ||||||||
| FaxNumber: | 5592612968 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 08/11/2014 | ||||||||
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| AuthorizedOfficialLastName: | MOCHIZUKI | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | MICHELE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5594381245 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G32450 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 611550700 | 01 | CA | USDL | OTHER | DN2660 | 01 | CA | RAILROAD MEDICARE | OTHER |