Organization
VIP SURGICARE, LLC
Active
Other names
VIP Surgicare
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK ANTHONY CHURUKIAN MD (MEDICAL DIRECTOR)
(408) 358-7000
Entity
Organization
Contact information
Practice address
15047 LOS GATOS BLVD., SUITE 150, LOS GATOS, CA 95032
(408) 358-7000
(408) 358-7005
Mailing address
15047 LOS GATOS BLVD., SUITE 150, LOS GATOS, CA 95032
(408) 358-7000
(408) 358-7005
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AAAASF2911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA129324
MEDICARE PTAN
CA
Enumeration date
11/10/2010
Last updated
01/29/2019
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