# AMBULATORY SURGERY CENTER OF YUMA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083681100
- **Authorized official:** DR. STEPHEN A WALLACE M.D. (AUTHORIZED SIGNER)
- **Authorized official phone:** (928) 343-2180

## Contact information

- **Practice address:** 2261 S AVENUE B, YUMA, AZ 85364-6103
- **Practice address phone:** (928) 343-2180
- **Practice address fax:** (928) 373-0754
- **Mailing address:** PO BOX 27340, PHOENIX, AZ 85061-7340
- **Mailing address phone:** (602) 943-9200
- **Mailing address fax:** (602) 216-3000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/07/2006
- **Last updated:** 12/06/2007