# DE ANZA SURGERY CENTER

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

## Provider details

- **NPI number:** 1831177567
- **Authorized official:** MR. EDWARD J TENNANT CASC (CEO/ADMINISTRATOR)
- **Authorized official phone:** (951) 320-7799

## Contact information

- **Practice address:** 4444 MAGNOLIA AVE, SUITE C, RIVERSIDE, CA 92501-4136
- **Practice address phone:** (951) 320-7799
- **Practice address fax:** (951) 274-3550
- **Mailing address:** 4444 MAGNOLIA AVE, SUITE C, RIVERSIDE, CA 92501-4136
- **Mailing address phone:** (951) 320-7799
- **Mailing address fax:** (951) 274-3550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 250000795 | CA | Yes |

## Other

- **Enumeration date:** 01/03/2006
- **Last updated:** 10/09/2008