Haven Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HAVEN SURGICAL CENTER LLC

Practice address

9120 Haven Ave
Suite 101
Rancho Cucuamonga, CA 91730-5413

Phone

(909) 295-5060

Fax

(909) 295-5061

NPI assigned

Dec 14, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Dharmesh Mehta, MD

Title

Owner

Phone

(626) 608-7321

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1700654191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 HAVEN AVE",
            "address_2": "SUITE 101",
            "city": "RANCHO CUCUAMONGA",
            "state": "CA",
            "postal_code": "917305413",
            "telephone_number": "909-295-5060",
            "fax_number": "909-295-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 HAVEN AVE",
            "address_2": "SUITE 101",
            "city": "RANCHO CUCUAMONGA",
            "state": "CA",
            "postal_code": "917305413",
            "telephone_number": "909-295-5060",
            "fax_number": "909-295-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "DHARMESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-608-7321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Rancho Cucuamonga, CA
• Providers in Rancho Cucuamonga, 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 29, 2024; 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.