Provider Demographics
NPI:1770061459
Name:WALNUT CREEK SURGERY CENTER LLC
Entity type:Organization
Organization Name:WALNUT CREEK SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD-60998
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:I
Authorized Official - Last Name:RASSAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-378-4949
Mailing Address - Street 1:460 N WIGET LN STE C
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2408
Mailing Address - Country:US
Mailing Address - Phone:925-378-4949
Mailing Address - Fax:925-891-9166
Practice Address - Street 1:460 N WIGET LN STE C
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2408
Practice Address - Country:US
Practice Address - Phone:925-378-4949
Practice Address - Fax:925-891-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical