# THE ADVANCED SURGICAL INSTITUTE OF RANCHO CUCAMONGA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Advanced Surgical Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982043428
- **Authorized official:** DR. MAZIN S AL-HAKEEM M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (909) 373-4380

## Contact information

- **Practice address:** 19671 BEACH BLVD, SUITE 321, HUNTINGTON BEACH, CA 92648-5901
- **Practice address phone:** (714) 969-2520
- **Practice address fax:** (714) 969-7480
- **Mailing address:** 8112 MILLIKEN AVE, SUITE 202, RANCHO CUCAMONGA, CA 91730-7471
- **Mailing address phone:** (909) 373-4380
- **Mailing address fax:** (909) 373-4388

## Taxonomy

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

## Other

- **Enumeration date:** 06/18/2013
- **Last updated:** 06/18/2013