Provider Demographics
NPI:1912393737
Name:MILLS SURGERY CENTER
Entity Type:Organization
Organization Name:MILLS SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:LERCEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-298-3123
Mailing Address - Street 1:4480 E. MILLS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-5206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:909-933-6585
Practice Address - Street 1:4480 E. MILLS CIRCLE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-5206
Practice Address - Country:US
Practice Address - Phone:909-294-2033
Practice Address - Fax:909-933-6585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLS SURGERY CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical