SIERRA AMBULATORY SURGERY CENTER NPI 1043254063

NPI Information

NPI: 1043254063
Provider Name: SIERRA AMBULATORY SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D1050971

Address:
400 SIERRA COLLEGE DRIVE
SUITE B
GRASS VALLEY, CA
ZIP 95945
Phone: (530) 272-3428
Get Directions

SIERRA AMBULATORY SURGERY CENTER is an ambulatory surgical clinic center in Grass Valley, CA. SIERRA AMBULATORY SURGERY CENTER NPI is 1043254063. The provider is registered as an organization entity type.

The provider's business location address is:

400 SIERRA COLLEGE DRIVE
SUITE B
GRASS VALLEY, CA
ZIP 95945-089
Phone: (530) 272-3428
Fax: (530) 272-3429

The provider's authorized official is John Edward Hagele .
The authorized official title is President and has the following contact phone number (530) 272-3411.

The CLIA number assigned to this NPI record is 05D1050971 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2006 and was last updated on 12/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	550000155	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	550000155	OTHER	CALIFORNIA	STATE LICENSE NUMBER
2	05C0001760	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »