Provider Demographics
NPI:1801064845
Name:VALLEY AMBULATORY SURGERY CENTER, LLC
Entity type:Organization
Organization Name:VALLEY AMBULATORY SURGERY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-442-9080
Mailing Address - Street 1:6840 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4401
Mailing Address - Country:US
Mailing Address - Phone:818-442-9080
Mailing Address - Fax:818-442-9081
Practice Address - Street 1:6840 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4401
Practice Address - Country:US
Practice Address - Phone:818-442-9080
Practice Address - Fax:818-442-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical