Provider Demographics
NPI:1720300312
Name:DELTA BAY SURGERY CENTER LLC
Entity type:Organization
Organization Name:DELTA BAY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-748-7248
Mailing Address - Street 1:PO BOX 5668
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-1668
Mailing Address - Country:US
Mailing Address - Phone:707-745-3112
Mailing Address - Fax:707-745-6822
Practice Address - Street 1:1208 E 5TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3502
Practice Address - Country:US
Practice Address - Phone:707-745-5500
Practice Address - Fax:707-745-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10BUS-00143261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF1959Medicare PIN