Mid-Valley Surgicenter Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MID-VALLEY SURGICENTER INC

Doing business as

Riverside Outpatient Surgical Institute

Practice address

4500 Brockton Ave
Suite 105
Riverside, CA 92501-4090

Phone

(951) 784-4088

Fax

(951) 784-4089

NPI assigned

Jan 7, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Robert A Hardesty, M.D.

Title

Medical Director

Phone

(951) 784-4088

Specialties & licenses 1

Addresses

Other names 1

• Riverside Outpatient Surgical Institute Doing business as

Locations

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1558759969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE",
            "address_2": "SUITE 105",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014090",
            "telephone_number": "951-784-4088",
            "fax_number": "951-784-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE",
            "address_2": "SUITE 105",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014090",
            "telephone_number": "951-784-4088",
            "fax_number": "951-784-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY SURGICENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "HARDESTY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-784-4088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Outpatient Surgical Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Nicole Michell, B.A.
• Ashley Michelson
• Jhovanny Michua
• Matthew Mickle
• Daniel Ray Micro Jr.
• Midas Medical Transportation, LLC
• Amanda Middleton, SLPA
• Gerald Michael Middleton, DDS
• Jerri Middleton, LCSW
• Meranda Middleton

• Ambulatory Surgical Clinic/Center in Riverside, CA
• Providers in Riverside, 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 Jan 7, 2015; 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.