Provider Demographics
NPI:1528261195
Name:ORCHARD CREEK SURGERY CENTER
Entity type:Organization
Organization Name:ORCHARD CREEK SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGANROTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-969-5600
Mailing Address - Street 1:301 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1043
Mailing Address - Country:US
Mailing Address - Phone:650-969-5600
Mailing Address - Fax:650-969-0360
Practice Address - Street 1:525 SOUTH DR STE 115
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4211
Practice Address - Country:US
Practice Address - Phone:650-969-5600
Practice Address - Fax:650-969-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81771261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF80568Medicare UPIN
CAZZZ27488ZMedicare PIN