Provider Demographics
NPI:1760803233
Name:PLACENTIA SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:PLACENTIA SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-223-9000
Mailing Address - Street 1:1041 E YORBA LINDA BLVD STE 200A
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3728
Mailing Address - Country:US
Mailing Address - Phone:714-223-9000
Mailing Address - Fax:714-223-9002
Practice Address - Street 1:1041 E YORBA LINDA BLVD STE 200A
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3728
Practice Address - Country:US
Practice Address - Phone:714-223-9000
Practice Address - Fax:714-223-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical