Provider Demographics
NPI:1336510486
Name:SACRAMENTO HEART AMBULATORY SURGERY CENTER, INC
Entity Type:Organization
Organization Name:SACRAMENTO HEART AMBULATORY SURGERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:BACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-830-2000
Mailing Address - Street 1:500 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6504
Mailing Address - Country:US
Mailing Address - Phone:916-830-2000
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6504
Practice Address - Country:US
Practice Address - Phone:916-830-2000
Practice Address - Fax:916-830-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical