Provider Demographics
NPI:1194907642
Name:TRI-COUNTY SURGERY CENTER, INC.
Entity type:Organization
Organization Name:TRI-COUNTY SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-676-5341
Mailing Address - Street 1:10390 SANTA MONICA BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6915
Mailing Address - Country:US
Mailing Address - Phone:858-216-5402
Mailing Address - Fax:310-855-3390
Practice Address - Street 1:10390 SANTA MONICA BLVD STE 340
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6915
Practice Address - Country:US
Practice Address - Phone:858-216-5402
Practice Address - Fax:310-855-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility