Organization
VALHALLA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH MOZINGO (AUTHORIZED OFFICIAL)
(805) 563-0363
Entity
Organization
Contact information
Practice address
4472 BROAD ST STE 150, SAN LUIS OBISPO, CA 93401-7990
(805) 364-8450
Mailing address
PO BOX 2140, EDMOND, OK 73083-2140
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2021
Last updated
03/05/2026
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