Provider Demographics
NPI:1790081263
Name:BAY CITY SURGERY CENTER INC.
Entity Type:Organization
Organization Name:BAY CITY SURGERY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-259-1327
Mailing Address - Street 1:2601 AIRPORT DR
Mailing Address - Street 2:380
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6140
Mailing Address - Country:US
Mailing Address - Phone:424-250-1680
Mailing Address - Fax:310-347-4054
Practice Address - Street 1:2557A PACIFIC COAST HWY
Practice Address - Street 2:SUITE 380
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7035
Practice Address - Country:US
Practice Address - Phone:310-997-1296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120013261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFQ648AMedicare PIN
FQ648AMedicare PIN