Provider Demographics
NPI:1598903221
Name:ARCADIA SURGICAL MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:ARCADIA SURGICAL MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:M
Authorized Official - Last Name:MINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-784-3125
Mailing Address - Street 1:PO BOX 1464
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91077-1464
Mailing Address - Country:US
Mailing Address - Phone:626-445-2371
Mailing Address - Fax:626-445-2618
Practice Address - Street 1:638 W DUARTE RD
Practice Address - Street 2:SUITE 18
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7616
Practice Address - Country:US
Practice Address - Phone:626-445-2371
Practice Address - Fax:626-445-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical