| Organization Name: | NOVAK URGENT CARE AMBULATORY SURGERY INC |
| NPI Number: | 1053719757 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE OGANYAN (COO) |
| Mailing Address: | 80545 Us Highway 111 Indio |
| State: | CA US |
| Postal Code: | 922018367 |
| Phone Number: | 7603479221 |
| Fax Number: | 7604795930 |
| NPI Enumeration Date: | 12/11/2014 |
| NPI Last Update Date: | 12/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 00G518830 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |