Provider Demographics
NPI:1508846122
Name:HEALTH & WELLNESS SURGERY CENTER
Entity type:Organization
Organization Name:HEALTH & WELLNESS SURGERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:JW
Authorized Official - Last Name:ROMEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:209-216-3400
Mailing Address - Street 1:1801 COLORADO AVE
Mailing Address - Street 2:STE 140
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382
Mailing Address - Country:US
Mailing Address - Phone:209-216-3470
Mailing Address - Fax:209-216-3475
Practice Address - Street 1:1801 COLORADO AVE
Practice Address - Street 2:STE 140
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382
Practice Address - Country:US
Practice Address - Phone:209-216-3470
Practice Address - Fax:209-216-3475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical