Organization
FREMONT AMBULATORY SURGERY CENTER, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MAZOROS (ADMINISTRATOR)
(510) 456-4650
Entity
Organization
Contact information
Practice address
39350 CIVIC CENTER DR SUITE 100, FREMONT, CA 94538-2331
(510) 456-4600
(510) 794-6822
Mailing address
39350 CIVIC CENTER DR STE 280, FREMONT, CA 94538-2331
(510) 456-4600
(510) 456-4601
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
140000527
CA
261QA1903X
Ambulatory Surgical Clinic/Center
140000600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR51053F
—
CA
Enumeration date
03/10/2006
Last updated
11/02/2017
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