# HAVEN SURGICAL CENTER LLC

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

## Provider details

- **NPI number:** 1700654191
- **Authorized official:** MR. DHARMESH MEHTA MD (OWNER)
- **Authorized official phone:** (626) 608-7321

## Contact information

- **Practice address:** 9120 HAVEN AVE, SUITE 101, RANCHO CUCUAMONGA, CA 91730-5413
- **Practice address phone:** (909) 295-5060
- **Practice address fax:** (909) 295-5061
- **Mailing address:** 9120 HAVEN AVE, SUITE 101, RANCHO CUCUAMONGA, CA 91730-5413
- **Mailing address phone:** (909) 295-5060
- **Mailing address fax:** (909) 295-5061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0000X | Pain Management Registered Nurse | — | NULL | — |
| 163WP0000X | Pain Management Registered Nurse | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/14/2023
- **Last updated:** 02/29/2024