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Organization

MIRAGE SURGERY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA FAVALE (ADMINISTRATOR)
(805) 581-5575
Entity
Organization

Contact information

Practice address
71949 HIGHWAY 111, SUITE 300, RANCHO MIRAGE, CA 92270-4826
(760) 568-2211
Mailing address
71949 HIGHWAY 111, SUITE 300, RANCHO MIRAGE, CA 92270-4826
(760) 568-2211

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
10/05/2008
Last updated
10/05/2008
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