Provider Demographics
NPI:1003017351
Name:CARLSBAD SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:CARLSBAD SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:LEGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-602-7872
Mailing Address - Street 1:6121 PASEO DEL NORTE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1159
Mailing Address - Country:US
Mailing Address - Phone:760-448-2488
Mailing Address - Fax:760-448-2478
Practice Address - Street 1:6121 PASEO DEL NORTE
Practice Address - Street 2:SUITE 100
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1159
Practice Address - Country:US
Practice Address - Phone:760-448-2488
Practice Address - Fax:760-448-2478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-C0001873Medicare PIN