NPI: 1932496908
Provider Name: CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC
Former Legal Business Name: CONCOURSE DIAGNOSTIC SURGERY CENTER,LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization
Specialization: Ambulatory Surgical
CLIA Number: 05D2029186
Address:
707 S GARFIELD AVE STE 101
ALHAMBRA, CA
ZIP 91801
Phone: (626) 872-0339
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CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC is an ambulatory surgical clinic center in Alhambra, CA. CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC NPI is 1932496908. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Concourse Diagnostic Surgery Center,llc.
The provider's business location address is:
707 S GARFIELD AVE STE 101
ALHAMBRA, CA
ZIP 91801-860
Phone: (626) 872-0339
Fax: (626) 872-0340
The provider's authorized official is Henry H. Chang .
The authorized official title is Medical Director and has the following contact phone number (626) 588-7789.
The CLIA number assigned to this NPI record is 05D2029186 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/29/2011 and was last updated on 8/21/2019.