Organization
OAK TREE ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDMUND WYCOFF BA (ADMINISTRATOR)
(626) 577-3415
Entity
Organization
Contact information
Practice address
751 CORDOVA ST, STE 2, PASADENA, CA 91101-2617
(626) 577-2525
(626) 577-2986
Mailing address
751 CORDOVA ST, STE 2, PASADENA, CA 91101-2617
(626) 577-2525
(626) 577-2986
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
930000938
CA
Other
Enumeration date
09/11/2006
Last updated
08/28/2008
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