Provider Demographics
NPI:1588356950
Name:CEDAR SURGERY CENTER
Entity type:Organization
Organization Name:CEDAR SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-318-1246
Mailing Address - Street 1:3275 APTOS RANCHO RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3971
Mailing Address - Country:US
Mailing Address - Phone:831-318-0010
Mailing Address - Fax:
Practice Address - Street 1:3275 APTOS RANCHO RD STE 1A
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-3971
Practice Address - Country:US
Practice Address - Phone:831-318-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTEREY BAY VASCULAR, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical