Provider Demographics
NPI:1477108496
Name:URRUTIA SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:URRUTIA SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:URRUTIA
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:775-233-5958
Mailing Address - Street 1:1237 HALLERTAU DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89441-4835
Mailing Address - Country:US
Mailing Address - Phone:775-233-5958
Mailing Address - Fax:
Practice Address - Street 1:1237 HALLERTAU DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89441-4835
Practice Address - Country:US
Practice Address - Phone:775-233-5958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty