Organization Active NPI

Inland Outpatient Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Riverside, CA
National Provider Identifier
1861702359
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
INLAND OUTPATIENT SURGERY CENTER, INC.
Practice address
4217 Luther St
Riverside, CA 92506-2853
Phone
(951) 600-7702
Fax
(951) 600-5935
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Authorized official

Name
Dr. Andrew Thio, M.D.
Title
Medical Director
Phone
(951) 600-7702

Specialties & licenses 1

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

Addresses

Primary practice location

4217 Luther St
Riverside, CA 92506-2853

Mailing address

41670 Ivy St
Suite B
Murrieta, CA 92562-9432
Phone (951) 600-7702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110215001190 CA Part B Supplier - Ambulatory Surgical Center 0749460202 Practice locations: Riverside, CA

Ambulatory surgical center certification: CCN 05C0001732

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
INLAND OUTPATIENT SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
May 13, 2005
Last certification
Dec 5, 2018
Ownership / control type
Proprietary
Facility address
4217 Luther Street
Riverside, CA 92506

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2027651Inland Outpatient Surgery Center4217 Luther St, Riverside, CA 92506Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1861702359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41670 IVY ST",
            "address_2": "SUITE B",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629432",
            "telephone_number": "951-600-7702",
            "fax_number": "951-600-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 LUTHER ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062853",
            "telephone_number": "951-600-7702",
            "fax_number": "951-600-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND OUTPATIENT SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "THIO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-600-7702",
        "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": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.