Provider Demographics
NPI:1043533300
Name:MIDTOWN SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:MIDTOWN SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRIPPEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-476-3972
Mailing Address - Street 1:920 29TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4306
Mailing Address - Country:US
Mailing Address - Phone:916-476-3972
Mailing Address - Fax:916-476-3974
Practice Address - Street 1:920 29TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4306
Practice Address - Country:US
Practice Address - Phone:916-476-3972
Practice Address - Fax:916-476-3974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical