# EAST BAY AMBULATORY SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1700175189
- **Authorized official:** CAROL CASTILLO (ADMINISTRATOR)
- **Authorized official phone:** (424) 249-3783

## Contact information

- **Practice address:** 1860 MOWRY AVE, STE 401 & 402, FREMONT, CA 94538-1730
- **Practice address phone:** (424) 249-3783
- **Mailing address:** 9190 W OLYMPIC BLVD, STE 139, BEVERLY HILLS, CA 90212-3540
- **Mailing address phone:** (414) 249-3783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | A84519 | CA | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A84519 | CA | Yes |

## Other

- **Enumeration date:** 04/06/2011
- **Last updated:** 04/06/2011