Provider Demographics
NPI:1417399411
Name:CARMEL VALLEY SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:CARMEL VALLEY SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:KARAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-259-3223
Mailing Address - Street 1:11943 EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2597
Mailing Address - Country:US
Mailing Address - Phone:858-259-3223
Mailing Address - Fax:858-259-3221
Practice Address - Street 1:11943 EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2597
Practice Address - Country:US
Practice Address - Phone:858-259-3223
Practice Address - Fax:858-259-3221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMIR M. KARAM INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82484261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical