Canyon Pinole Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CANYON PINOLE SURGERY CENTER, LP

Practice address

1700 San Pablo Ave
Ste. D
Pinole, CA 94564-2068

Phone

(510) 724-9500

Fax

(510) 724-9511

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

David Park

Title

Administrator

Phone

(510) 724-9500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Canyon Pinole Surgery Center LPCCN 05C0001710

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Arun Anand, MD

  • Pain Medicine (Anesthesiology) Physician
  • Benicia, CA
  • NPI 1578521050
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1497791040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SAN PABLO AVE STE D",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642082",
            "telephone_number": "510-724-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SAN PABLO AVE",
            "address_2": "STE. D",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642068",
            "telephone_number": "510-724-9500",
            "fax_number": "510-724-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON PINOLE SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "510-724-9500"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie G. Byrd, M.D.
• Ma. Yolanda Alonzo Caboboy, D.D.S.
• Yuhang Cai, PT
• Katharine McFadden Caldwell
• Laura Calixtro
• John Henson Rivera Caparas, DO
• Maribel Rebekha Cardenas
• Dimitri Rizal Cardona
• Carlene a Mendieta DDS
• Carolyn L. Yu, DDS, Inc

• Ambulatory Surgical Clinic/Center in Pinole, CA
• Providers in Pinole, 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 Sep 8, 2022; 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.