Provider Demographics
NPI:1679504690
Name:SANTA CLARITA SURGERY CENTER LP
Entity Type:Organization
Organization Name:SANTA CLARITA SURGERY CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-567-0269
Mailing Address - Street 1:26357 MCBEAN PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4489
Mailing Address - Country:US
Mailing Address - Phone:661-799-8300
Mailing Address - Fax:661-799-8333
Practice Address - Street 1:26357 MCBEAN PKWY
Practice Address - Street 2:STE 100
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-4489
Practice Address - Country:US
Practice Address - Phone:661-799-8300
Practice Address - Fax:661-799-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05C0001764Medicare Oscar/Certification
CAS051764Medicare PIN