# LVC SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1164930491
- **Authorized official:** VIVIAN OWYONG (CREDENTIALING CONTACT)
- **Authorized official phone:** (702) 802-3456

## Contact information

- **Practice address:** 1050 S RAINBOW BLVD STE 100, LAS VEGAS, NV 89145-6231
- **Practice address phone:** (702) 802-3456
- **Practice address fax:** (702) 802-3457
- **Mailing address:** PO BOX 778210, HENDERSON, NV 89077-8210
- **Mailing address phone:** (702) 802-3456
- **Mailing address fax:** (702) 802-3457

## Taxonomy

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

## Other

- **Enumeration date:** 01/22/2018
- **Last updated:** 10/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1164930491 | — | NV |