Provider Demographics
NPI:1326362393
Name:PHYSICIANS SURGICAL CARE AFFILIATES
Entity Type:Organization
Organization Name:PHYSICIANS SURGICAL CARE AFFILIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-424-7600
Mailing Address - Street 1:3505 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3907
Mailing Address - Country:US
Mailing Address - Phone:562-424-7600
Mailing Address - Fax:562-424-7601
Practice Address - Street 1:3505 LONG BEACH BLVD
Practice Address - Street 2:SUITE 1H
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3907
Practice Address - Country:US
Practice Address - Phone:562-424-7600
Practice Address - Fax:562-424-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical