Organization Active NPI

San Dimas Surgical Medical Center

  • Ambulatory Surgical Clinic/Center
  • San Dimas, CA
National Provider Identifier
1730454737
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SAN DIMAS SURGICAL MEDICAL CENTER
Practice address
1359 W Arrow Hwy
San Dimas, CA 91773-2330
Phone
(818) 784-3125
Fax
(818) 784-3126
NPI assigned
Mar 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Authorized official

Name
Dr. Isaac Michael Minehart Sr., M.D
Title
Medical Director
Phone
(818) 784-3125

Specialties & licenses 1

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

Addresses

Primary practice location

1359 W Arrow Hwy
San Dimas, CA 91773-2330

Mailing address

16250 Ventura Blvd Ste 165
Encino, CA 91436-2273
Phone (818) 784-3125

National Provider Directory

National Provider Directory

Locations

1359 W Arrow Hwy
San Dimas, CA 91773
Phone (818) 784-3125

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1730454737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16250 VENTURA BLVD STE 165",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362273",
            "telephone_number": "818-784-3125",
            "fax_number": "818-784-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 W ARROW HWY",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732330",
            "telephone_number": "818-784-3125",
            "fax_number": "818-784-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIMAS SURGICAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "MINEHART",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-784-3125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "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": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.