# CANYON SPECIALTY SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1154805240
- **Authorized official:** MR. JAMSHID SHADJAREH RN (CHAIRMAN, GOVERNING BODY)
- **Authorized official phone:** (714) 462-3005

## Contact information

- **Practice address:** 145 S CHAPARRAL CT STE 101, ANAHEIM, CA 92808-2265
- **Practice address phone:** (714) 462-3005
- **Mailing address:** 145 S CHAPARRAL CT STE 101, ANAHEIM, CA 92808-2265
- **Mailing address phone:** (714) 462-3005

## Taxonomy

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

## Other

- **Enumeration date:** 09/24/2018
- **Last updated:** 09/24/2018