ENT FACIAL SURGERY CENTER LLC NPI 1841259694

NPI Information

NPI: 1841259694
Provider Name: ENT FACIAL SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D0718554

Address:
1351 E SPRUCE AVE
FRESNO, CA
ZIP 93720
Phone: (559) 432-3303
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ENT FACIAL SURGERY CENTER LLC is an ambulatory surgical clinic center in Fresno, CA. ENT FACIAL SURGERY CENTER LLC NPI is 1841259694. The provider is registered as an organization entity type.

The provider's business location address is:

1351 E SPRUCE AVE
FRESNO, CA
ZIP 93720-342
Phone: (559) 432-3303
Fax: (559) 432-1468

The provider's authorized official is Melissa Vainauskas .
The authorized official title is Director Of Nursing and has the following contact phone number (559) 432-3724.

The CLIA number assigned to this NPI record is 05D0718554 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2006 and was last updated on 2/27/2018.

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

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	SURG01199F	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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