Organization Name: | GENESIS AMBULATORY SURGERY CENTER, INC. |
NPI Number: | 1609108083 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YASSER HILMY SALEM (PRESIDENT) |
Mailing Address: | 26781 Portola Pkwy Suite 4-e Foothill Ranch |
State: | CA US |
Postal Code: | 926101758 |
Phone Number: | 9492511502 |
Fax Number: | 9492511522 |
NPI Enumeration Date: | 02/09/2010 |
NPI Last Update Date: | 02/23/2016 |
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: |