Provider Demographics
NPI:1083711568
Name:NATRAJ SURGERY CENTER INC.
Entity Type:Organization
Organization Name:NATRAJ SURGERY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASC SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JYOTSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-788-0505
Mailing Address - Street 1:555 WEST PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 WEST PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257
Practice Address - Country:US
Practice Address - Phone:559-788-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000077261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05C0001771Medicare ID - Type UnspecifiedASC PROVIDER NUMBER