Provider Demographics
NPI:1326361460
Name:HAPY BEAR SURGERY CENTER LLC
Entity Type:Organization
Organization Name:HAPY BEAR SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH
Authorized Official - Phone:559-732-4279
Mailing Address - Street 1:1979 HILLMAN ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-1601
Mailing Address - Country:US
Mailing Address - Phone:559-732-4279
Mailing Address - Fax:559-688-4455
Practice Address - Street 1:1979 HILLMAN ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-1601
Practice Address - Country:US
Practice Address - Phone:559-732-4279
Practice Address - Fax:559-688-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22015261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental