Organization
TRESANTI SURGICAL CENTER LLC
Active
Other names
Tresanti Medical Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
5201 NORRIS CANYON ROAD, #100, SAN RAMON, CA 94583
(925) 973-0605
(925) 973-0653
Mailing address
5201 NORRIS CANYON ROAD, #100, SAN RAMON, CA 94583
(925) 973-0605
(925) 973-0653
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
140000665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140000665
STATE OF CA DEPT OF HEALT
CA
01
—
P00069274
MEDICARE RAILROAD
CA
Enumeration date
10/06/2006
Last updated
09/13/2024
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