WAVERLEY SURGERY CENTER LLC NPI 1619944824

NPI Information

NPI: 1619944824
Provider Name: WAVERLEY SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
400 FOREST AVE
PALO ALTO, CA
ZIP 94301
Phone: (650) 324-0600
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WAVERLEY SURGERY CENTER LLC is an ambulatory surgical clinic center in Palo Alto, CA. WAVERLEY SURGERY CENTER LLC NPI is 1619944824. The provider is registered as an organization entity type.

The provider's business location address is:

400 FOREST AVE
PALO ALTO, CA
ZIP 94301-608
Phone: (650) 324-0600
Fax: (650) 289-1620

The provider's authorized official is Phillip Clendenin .
The authorized official title is President Of Llc and has the following contact phone number (615) 240-3820.

The enumeration date for this NPI number is 3/7/2006 and was last updated on 7/13/2015.

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	220000472	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	SUR01547F	OTHER	CALIFORNIA	MEDICAL
2	05C0001547	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA

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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