Organization
CONGRESS MEDICAL SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J FRAIPONT MD (MEDICAL DIRECTOR)
(626) 795-8051
Entity
Organization
Contact information
Practice address
800 S RAYMOND AVE, PASADENA, CA 91105
(626) 795-8051
(626) 795-0356
Mailing address
PO BOX 90730, PASADENA, CA 91109-0730
(626) 795-8051
(626) 795-7374
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G81716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZH1905D
BLUE SHIELD
CA
Enumeration date
06/23/2008
Last updated
10/20/2010
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