Provider Demographics
NPI:1437510153
Name:SURGICAL PRECISION, INC
Entity Type:Organization
Organization Name:SURGICAL PRECISION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-278-9477
Mailing Address - Street 1:12277 APPLE VALLEY RD
Mailing Address - Street 2:#450
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-1701
Mailing Address - Country:US
Mailing Address - Phone:973-738-7336
Mailing Address - Fax:
Practice Address - Street 1:18144 US HIGHWAY 18
Practice Address - Street 2:SUITE 130
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2212
Practice Address - Country:US
Practice Address - Phone:760-278-9477
Practice Address - Fax:760-813-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117875208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty