OPTIMUM SURGICAL CENTER LLC NPI 1992238661

NPI Information

OPTIMUM SURGICAL CENTER, LLC is an ambulatory surgical clinic center in Phoenix, AZ. OPTIMUM SURGICAL CENTER, LLC NPI is 1992238661. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Nascent Paradise Valley Surgical Center.

The provider's business location address is:

20045 N 19TH AVE BLDG 12
PHOENIX, AZ
ZIP 85027-270
Phone: (480) 766-6819

The provider's authorized official is Grant Cook .
The authorized official title is Owner/manager and has the following contact phone number (602) 313-8110.

The CLIA number assigned to this NPI record is 03D2126991 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/9/2017 and was last updated on 4/23/2020.

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:

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