# PARADISE SURGERY CENTER

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

## Provider details

- **NPI number:** 1245765924
- **Authorized official:** DR. JEROME NISWONGER M.D. (OWNER)
- **Authorized official phone:** (530) 514-8282

## Contact information

- **Practice address:** 6283 CLARK RD, SUITE 11, PARADISE, CA 95969-4100
- **Practice address phone:** (530) 514-8282
- **Mailing address:** 6283 CLARK RD, SUITE 11, PARADISE, CA 95969-4100
- **Mailing address phone:** (530) 514-8282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 05C001855 | CA | Yes |

## Other

- **Enumeration date:** 05/01/2017
- **Last updated:** 05/01/2017