Organization
GRASS VALLEY OUTPATIENT SURGERY CENTER LP
Active
Other names
Grass Valley Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
(480) 567-9026
Entity
Organization
Contact information
Practice address
408 SIERRA COLLEGE DR, GRASS VALLEY, CA 95945-5089
(530) 271-2282
(530) 271-2287
Mailing address
408 SIERRA COLLEGE DR, GRASS VALLEY, CA 95945-5089
(530) 271-2282
(530) 271-2287
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00935009
RAILROAD MEDICARE
CA
Enumeration date
07/15/2010
Last updated
10/07/2024
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