Provider Demographics
NPI:1841229705
Name:ADVANCED MEDICAL SURGERY CENTER A MEDICAL CORPORATION
Entity type:Organization
Organization Name:ADVANCED MEDICAL SURGERY CENTER A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-422-5240
Mailing Address - Street 1:1117 LOS PALOS DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3853
Mailing Address - Country:US
Mailing Address - Phone:831-422-5240
Mailing Address - Fax:831-422-5310
Practice Address - Street 1:1117 LOS PALOS DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3853
Practice Address - Country:US
Practice Address - Phone:831-422-5240
Practice Address - Fax:831-422-5310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000711261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ31737ZOtherMEDICARE PTAN