REGENCY AMBULATORY SURGERY CENTER ONE LLC NPI 1073155834

NPI Information

NPI: 1073155834
Provider Name: REGENCY AMBULATORY SURGERY CENTER ONE, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 03D2184401

Address:
14753 W MOUNTAIN VIEW BLVD
SURPRISE, AZ
ZIP 85374
Phone: (623) 243-9077
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REGENCY AMBULATORY SURGERY CENTER ONE, LLC is an ambulatory surgical clinic center in Surprise, AZ. REGENCY AMBULATORY SURGERY CENTER ONE, LLC NPI is 1073155834. The provider is registered as an organization entity type.

The provider's business location address is:

14753 W MOUNTAIN VIEW BLVD
SURPRISE, AZ
ZIP 85374
Phone: (623) 243-9077

The provider's authorized official is Jason Lee Mussman .
The authorized official title is Ceo/sole Member and has the following contact phone number (623) 243-9077.

The CLIA number assigned to this NPI record is 03D2184401 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/14/2019 and was last updated on 10/14/2019.

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			Yes

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: 11/14/2023

NPI Synchronization or Removal

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