Organization
CASA COLINA SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
255 E BONITA AVE, BUILDING 3 B, POMONA, CA 91767-1923
(909) 593-3550
(909) 593-5223
Mailing address
255 E BONITA AVE, BUILDING 3 B, POMONA, CA 91767-1923
(909) 593-3550
(909) 593-5223
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
550000065
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00275882
RAILROAD MEDICARE
CA
05
—
SUR01741F
—
CA
Enumeration date
07/30/2006
Last updated
06/22/2022
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