Provider Demographics
NPI:1457707473
Name:TARG SURGERY CENTER
Entity Type:Organization
Organization Name:TARG SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:TARG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-814-3025
Mailing Address - Street 1:800 E GREENWICH PL
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3416
Mailing Address - Country:US
Mailing Address - Phone:650-814-3025
Mailing Address - Fax:650-856-7909
Practice Address - Street 1:800 E GREENWICH PL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-3416
Practice Address - Country:US
Practice Address - Phone:650-814-3025
Practice Address - Fax:650-856-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP32185261QA1903X
CAMGA56261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMGA56OtherDENTAL BOARD OF CA GENERAL ANESTHESIA PERMIT
CAFNP32185OtherMEDICAL BOARD OF CA FICTITIOUS NAME PERMIT