Provider Demographics
NPI:1821536343
Name:SALUTARIS SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:SALUTARIS SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:P
Authorized Official - Last Name:MACIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-359-0500
Mailing Address - Street 1:9041 MAGNOLIA AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3957
Mailing Address - Country:US
Mailing Address - Phone:951-359-0500
Mailing Address - Fax:951-359-0550
Practice Address - Street 1:9041 MAGNOLIA AVE STE 301
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3957
Practice Address - Country:US
Practice Address - Phone:951-359-0500
Practice Address - Fax:951-359-0550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86739261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical