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Organization

EAST BAY AMBULATORY SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL CASTILLO (ADMINISTRATOR)
(424) 249-3783
Entity
Organization

Contact information

Practice address
1860 MOWRY AVE, STE 401 & 402, FREMONT, CA 94538-1730
(424) 249-3783
Mailing address
9190 W OLYMPIC BLVD, STE 139, BEVERLY HILLS, CA 90212-3540
(414) 249-3783

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
A84519
CA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A84519
CA

Other

Enumeration date
04/06/2011
Last updated
04/06/2011
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