Provider Demographics
NPI:1083382154
Name:TRI-CITY SURGICAL CENTERS, LLC
Entity Type:Organization
Organization Name:TRI-CITY SURGICAL CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JASKAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-835-6100
Mailing Address - Street 1:6343 E MAIN ST STE 12
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8955
Mailing Address - Country:US
Mailing Address - Phone:480-835-6100
Mailing Address - Fax:
Practice Address - Street 1:143 S 63RD STREET
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-835-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical