Provider Demographics
NPI:1013633163
Name:VALLEY SURGERY CENTER
Entity Type:Organization
Organization Name:VALLEY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINTANAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-647-5101
Mailing Address - Street 1:1335 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2536
Mailing Address - Country:US
Mailing Address - Phone:510-647-5101
Mailing Address - Fax:
Practice Address - Street 1:1640 W YOSEMITE AVE STE 2
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-5192
Practice Address - Country:US
Practice Address - Phone:510-647-5101
Practice Address - Fax:510-647-5105
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAIN AND REHABILIATION CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain