Provider Demographics
NPI:1326191958
Name:T SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:T SURGERY CENTER, LLC
Other - Org Name:VENTURA ORTHOPEDICS SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/BOARD CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-232-3800
Mailing Address - Street 1:3525 LOMA VISTA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3101
Mailing Address - Country:US
Mailing Address - Phone:805-641-6434
Mailing Address - Fax:805-641-6437
Practice Address - Street 1:3525 LOMA VISTA RD
Practice Address - Street 2:SUITE B
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3101
Practice Address - Country:US
Practice Address - Phone:805-641-6434
Practice Address - Fax:805-641-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000270261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050000270OtherDHS LICENSE