Provider Demographics
NPI:1801199039
Name:HUNTINGTON AMBULATORY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:HUNTINGTON AMBULATORY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-397-5555
Mailing Address - Street 1:625 S. FAIR OAKS AVENUE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:626-229-8999
Mailing Address - Fax:626-229-8980
Practice Address - Street 1:625 S. FAIR OAKS AVENUE
Practice Address - Street 2:SUITE 380
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:626-229-8999
Practice Address - Fax:626-229-8980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN/A261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical