| Organization Name: | TRACY SURGERY CENTER, LLC |
| NPI Number: | 1013104389 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEE J. MAREK (SECRETARY) |
| Mailing Address: | 2160 W Grant Line Rd Suite 120 Tracy |
| State: | CA US |
| Postal Code: | 953777330 |
| Phone Number: | 2098365680 |
| Fax Number: | |
| NPI Enumeration Date: | 10/01/2007 |
| NPI Last Update Date: | 06/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |