Provider Demographics
NPI:1891721494
Name:VALENCIA SURGICAL CENTER
Entity Type:Organization
Organization Name:VALENCIA SURGICAL CENTER
Other - Org Name:VALENCIA AMBUALTORY SURGERY CTR
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:III
Authorized Official - Credentials:MPH
Authorized Official - Phone:310-273-8885
Mailing Address - Street 1:9001 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1838
Mailing Address - Country:US
Mailing Address - Phone:310-273-8885
Mailing Address - Fax:310-273-8662
Practice Address - Street 1:9001 WILSHIRE BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1838
Practice Address - Country:US
Practice Address - Phone:310-273-8885
Practice Address - Fax:310-273-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical