Provider Demographics
NPI:1982674065
Name:HEMET HEALTHCARE SURGICENTER, INC.
Entity Type:Organization
Organization Name:HEMET HEALTHCARE SURGICENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALI
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHAUDHURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-782-8812
Mailing Address - Street 1:301 N SAN JACINTO ST
Mailing Address - Street 2:STE B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3113
Mailing Address - Country:US
Mailing Address - Phone:951-765-1717
Mailing Address - Fax:951-765-1716
Practice Address - Street 1:301 N SAN JACINTO ST
Practice Address - Street 2:STE B
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3113
Practice Address - Country:US
Practice Address - Phone:951-765-1717
Practice Address - Fax:951-765-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ38207ZMedicare UPIN