| Organization Name: | CAMPUS SURGERY CENTER LLC |
| NPI Number: | 1063427557 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP CLENDENIN (PRESIDENT OF LLC) |
| Mailing Address: | 901 Campus Dr Suite 102 Daly City |
| State: | CA US |
| Postal Code: | 940154900 |
| Phone Number: | 6509912000 |
| Fax Number: | 6507558638 |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 07/13/2015 |
| 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: | |