Provider Demographics
NPI:1346565066
Name:ALTA SURGERY CENTER, LLC.
Entity Type:Organization
Organization Name:ALTA SURGERY CENTER, LLC.
Other - Org Name:ALTA SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:TARDIEU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-737-1770
Mailing Address - Street 1:401 MONTEREY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3449
Mailing Address - Country:US
Mailing Address - Phone:831-737-1770
Mailing Address - Fax:831-737-1740
Practice Address - Street 1:401 MONTEREY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3449
Practice Address - Country:US
Practice Address - Phone:831-737-1770
Practice Address - Fax:831-737-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical