Provider Demographics
NPI:1073758264
Name:TRINITY PLAZA SURGERY CENTER LLC
Entity Type:Organization
Organization Name:TRINITY PLAZA SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-334-3411
Mailing Address - Street 1:10200 TRINITY PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-7249
Mailing Address - Country:US
Mailing Address - Phone:209-323-3480
Mailing Address - Fax:
Practice Address - Street 1:10200 TRINITY PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-7249
Practice Address - Country:US
Practice Address - Phone:209-323-3480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical