# EVERGREEN SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1538618368
- **Authorized official:** DR. HECTOR CERVANTES DPM (PARTNER)
- **Authorized official phone:** (408) 620-5723

## Contact information

- **Practice address:** 2365 QUIMBY RD STE 180, SAN JOSE, CA 95122-1337
- **Practice address phone:** (408) 620-5675
- **Practice address fax:** (408) 223-1534
- **Mailing address:** 2365 QUIMBY RD STE 180, SAN JOSE, CA 95122-1337
- **Mailing address phone:** (408) 620-5675
- **Mailing address fax:** (408) 223-1534

## Taxonomy

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

## Other

- **Enumeration date:** 09/21/2016
- **Last updated:** 02/04/2019