Basic Information
| Provider Information | |||||||||
| NPI: | 1891772349 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH ANAHEIM SURGICENTER LTD | ||||||||
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| OtherOrganizationName: | NORTH ANAHEIM SURGICENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 BURTON HILLS BLVD STE 100 | ||||||||
| Address2: | ATTENTION: CAROL BAILEY | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372156409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156656000 | ||||||||
| FaxNumber: | 6156656184 | ||||||||
| Practice Location | |||||||||
| Address1: | 1154 N EUCLID ST | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928011955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146356272 | ||||||||
| FaxNumber: | 7146350943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2005 | ||||||||
| LastUpdateDate: | 11/03/2016 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6156656000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 060000305 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.