Organization
SIERRA AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EDWARD HAGELE M.D. (PRESIDENT)
(530) 272-3411
Entity
Organization
Contact information
Practice address
400 SIERRA COLLEGE DRIVE, SUITE B, GRASS VALLEY, CA 95945-5089
(530) 272-3428
(530) 272-3429
Mailing address
400 SIERRA COLLEGE DRIVE, SUITE B, GRASS VALLEY, CA 95945-5089
(530) 272-3428
(530) 272-3429
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
550000155
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550000155
STATE LICENSE NUMBER
CA
Enumeration date
06/16/2006
Last updated
12/27/2012
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