| Organization Name: | ADVANCED SURGICAL GROUP |
| NPI Number: | 1073908604 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAYVAN HADDADAN (OWNER/PROVIDER) |
| Mailing Address: | 2160 Sunset Blvd Suite 502 Rocklin |
| State: | CA US |
| Postal Code: | 957654790 |
| Phone Number: | 8885432243 |
| Fax Number: | 9167718515 |
| NPI Enumeration Date: | 03/31/2015 |
| NPI Last Update Date: | 03/31/2015 |
| 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: | |