# RIDGECREST SPECIALTY SURGERY CENTER, A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1851678981
- **Authorized official:** DANIEL TAHERI M.D. (MEDICAL DIRECTOR/ OWNER)
- **Authorized official phone:** (661) 947-4600

## Contact information

- **Practice address:** 1200 N. CHINA LAKE BLVD, RIDGECREST, CA 93555-2665
- **Practice address phone:** (661) 947-4600
- **Mailing address:** 1200 N. CHINA LAKE BLVD., RIDGECREST, CA 93555-2665

## Taxonomy

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

## Other

- **Enumeration date:** 11/03/2011
- **Last updated:** 11/03/2011