Provider Demographics
NPI:1922163757
Name:HANFORD SURGERY CENTER
Entity Type:Organization
Organization Name:HANFORD SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACG
Authorized Official - Phone:559-583-8889
Mailing Address - Street 1:1360 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5921
Mailing Address - Country:US
Mailing Address - Phone:559-583-8889
Mailing Address - Fax:559-583-8883
Practice Address - Street 1:1360 BAILEY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5921
Practice Address - Country:US
Practice Address - Phone:559-583-8889
Practice Address - Fax:559-583-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASUR01487FMedicaid
CAZZZ19674ZMedicare ID - Type UnspecifiedMEDICARE ID