Provider Demographics
NPI:1477792828
Name:PRECISION SURGICENTER LLC
Entity Type:Organization
Organization Name:PRECISION SURGICENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-494-0800
Mailing Address - Street 1:39180 FARWELL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1052
Mailing Address - Country:US
Mailing Address - Phone:510-494-0800
Mailing Address - Fax:510-494-0804
Practice Address - Street 1:39180 FARWELL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1052
Practice Address - Country:US
Practice Address - Phone:510-494-0800
Practice Address - Fax:510-494-0804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
F1731OtherMEDICARE PTAN