Provider Demographics
NPI:1497120463
Name:THE CARDIOVASCULAR SURGICAL CENTER, INC.
Entity Type:Organization
Organization Name:THE CARDIOVASCULAR SURGICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-241-1144
Mailing Address - Street 1:2425 SONOMA ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-3026
Mailing Address - Country:US
Mailing Address - Phone:530-241-1144
Mailing Address - Fax:530-241-1142
Practice Address - Street 1:2415 SONOMA ST STE B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3026
Practice Address - Country:US
Practice Address - Phone:530-241-1144
Practice Address - Fax:530-241-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49275261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical