St Matthews Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ST MATTHEWS SURGERY CENTER

Practice address

104 Saint Matthews Ave
San Mateo, CA 94401-2807

Phone

(661) 472-4177

Fax

(760) 564-7874

NPI assigned

Jul 9, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elena C Serda

Title

Director

Phone

(661) 472-4177

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1194131235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SAINT MATTHEWS AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012807",
            "telephone_number": "661-472-4177",
            "fax_number": "760-564-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SAINT MATTHEWS AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012807",
            "telephone_number": "661-472-4177",
            "fax_number": "760-564-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MATTHEWS SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "SERDA",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "661-472-4177"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christine St. Charles
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• Jessica Ann Stafford-Eady, LVN
• Marguerite Stagg
• Susan Michelle Stahl, MFT

• Ambulatory Surgical Clinic/Center in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.