| Organization Name: | SEBASTOPOL ASC, L.P. |
| NPI Number: | 1154440972 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC J KAHLE (CORPORATE OFFICER) |
| Mailing Address: | 6880 Palm Ave Sebastopol |
| State: | CA US |
| Postal Code: | 954724270 |
| Phone Number: | 7078237628 |
| Fax Number: | 7078231521 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 01/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 010000189 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |