De Anza Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

250000795 Issued in CA

Legal business name

DE ANZA SURGERY CENTER

Practice address

4444 Magnolia Ave
Suite C
Riverside, CA 92501-4136

Phone

(951) 320-7799

Fax

(951) 274-3550

NPI assigned

Jan 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Edward J Tennant, CASC

Title

Ceo/Administrator

Phone

(951) 320-7799

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Thomas Milan Mirich III, MD

  • Orthopaedic Surgery Physician
  • Ellensburg, WA
  • NPI 1952327025
  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1831177567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 MAGNOLIA AVE",
            "address_2": "SUITE C",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014136",
            "telephone_number": "951-320-7799",
            "fax_number": "951-274-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 MAGNOLIA AVE",
            "address_2": "SUITE C",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014136",
            "telephone_number": "951-320-7799",
            "fax_number": "951-274-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE ANZA SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "TENNANT",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "951-320-7799",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "250000795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin De Anda- Fuentes
• Carol De Anda
• Lesly Monic De Anda
• Nicole De Angelis
• De Anza Obstetrics and Gynecology Medical Group, Inc.
• Austin Taylor De Falkenberg
• Kaylee Elizabeth De Falkenberg, B.S.
• Allison Marie De Franco, RN
• Adriana De Groot
• Angela Rose De Castro De Guzman

• 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 Oct 9, 2008; 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.