Provider Demographics
NPI:1952493124
Name:MAXIMUM SURGERY MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:MAXIMUM SURGERY MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDYFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-902-5022
Mailing Address - Street 1:11760 CENTRAL AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1900
Mailing Address - Country:US
Mailing Address - Phone:909-902-5022
Mailing Address - Fax:909-902-1013
Practice Address - Street 1:11760 CENTRAL AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-1900
Practice Address - Country:US
Practice Address - Phone:909-902-5022
Practice Address - Fax:909-902-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04363ZMedicare PIN