Organization Active NPI

San Joaquin Valley Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Modesto, CA
National Provider Identifier
1376893784
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SAN JOAQUIN VALLEY SURGERY CENTER
Practice address
1524 McHenry Ave Ste 240
Modesto, CA 95350-4566
Phone
(888) 942-9997
NPI assigned
Sep 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Ms. Monica Porter
Title
Assistant Manager
Phone
(888) 942-9997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1524 McHenry Ave Ste 240
Modesto, CA 95350-4566

Mailing address

269 S Beverly Dr Ste 353
Beverly Hills, CA 90212-3851

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1376893784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 S BEVERLY DR STE 353",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE STE 240",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504566",
            "telephone_number": "888-942-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN VALLEY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "ASSISTANT MANAGER",
        "authorized_official_telephone_number": "888-942-9997",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.