San Gabriel Ambulatory Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

550000023 Issued in CA

Legal business name

SAN GABRIEL AMBULATORY SURGERY CENTER, LP

Practice address

288 N Santa Anita Ave Ste 404
Arcadia, CA 91006-3183

Phone

(626) 300-5300

Fax

(626) 300-5355

NPI assigned

Nov 17, 2006

Last updated

Feb 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tom Chang, MD

Title

Owner

Phone

(626) 676-0838

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

San Gabriel Ambulatory Surgery CenterCCN 05C0001727

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Dignity Health

  dba Mercy Gilbert Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088

  Member Of

  NPD member

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1336213099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 N SANTA ANITA AVE STE 404",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063183",
            "telephone_number": "626-300-5300",
            "fax_number": "626-300-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 N SANTA ANITA AVE STE 404",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063183",
            "telephone_number": "626-300-5300",
            "fax_number": "626-300-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL AMBULATORY SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-676-0838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "550000023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01727F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jan Laudise Salvay, MA, MFT
• Sam P Chia MD Inc
• Hannah Sampson
• Samuel Lee DMD Inc. (Imprint Family Dentistry)
• San Dimas Pain Management Medical Center Inc.
• San Gabriel Orthopaedic Medical Group Inc
• San Gabriel Women's Health Inc
• Billicent San Juan, PSYD
• Jennifer Crystal Sanchez Baca
• Christopher Sanchez

• Ambulatory Surgical Clinic/Center in Arcadia, CA
• Providers in Arcadia, 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 Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.