| NPI | 1851695860 |
|---|---|
| Former Legal Business Name | THE SURGERY CENTER ON SAND CANYON SHADY CANYON EXIT |
| Entity Type | Organization |
| Authorized Contact | ALBERT BEOMJIN CHANG Medical Director 949-585-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |