| Organization Name: | VIP SURGICARE, LLC |
| NPI Number: | 1053612853 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIRK ANTHONY CHURUKIAN (OWNER) |
| Mailing Address: | 15047 Los Gatos Blvd. Suite 150 Los Gatos |
| State: | CA US |
| Postal Code: | 95032 |
| Phone Number: | 4083587000 |
| Fax Number: | 4083587005 |
| NPI Enumeration Date: | 11/10/2010 |
| NPI Last Update Date: | 06/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | AAAASF2911 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |