# SAN JOAQUIN VALLEY SURGERY CENTER

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

## Provider details

- **NPI number:** 1376893784
- **Authorized official:** MS. MONICA PORTER (ASSISTANT MANAGER)
- **Authorized official phone:** (888) 942-9997

## Contact information

- **Practice address:** 1524 MCHENRY AVE STE 240, MODESTO, CA 95350-4566
- **Practice address phone:** (888) 942-9997
- **Mailing address:** 269 S BEVERLY DR STE 353, BEVERLY HILLS, CA 90212-3851

## Taxonomy

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

## Other

- **Enumeration date:** 09/12/2012
- **Last updated:** 09/12/2012