4Th Street Laser & Surgery Center Inc in Santa Rosa - Ambulatory Surgical
4Th Street Laser & Surgery Center Inc - NPI 1902964174
4Th Street Laser & Surgery Center Inc is a Ambulatory Surgical in Santa Rosa, California. 4Th Street Laser & Surgery Center Inc practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for 4Th Street Laser & Surgery Center Inc is 1902964174. The last update date is 2013-01-17.
4Th Street Laser & Surgery Center Inc's current location address is 1720 4th St, Santa Rosa, California. You can contact this provider via phone number 7075468100 and fax number 7075446438. The mailing address for 4Th Street Laser & Surgery Center Inc is 1720 4th St, Santa Rosa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | 4Th Street Laser & Surgery Center Inc |
|---|---|
| Address | 1720 4th St, Santa Rosa, California |
| Phone Number | 7075468100 |
| Fax Number | 7075446438 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Clark Elayne |
| Credentials | RN CASC |
| Telephone Number | 7075468100 |
NPI Number Detail
| NPI Number | 1902964174 |
|---|---|
| Provider Enumeration Date | 2006-12-04 |
| Last Updated Date | 2013-01-17 |
Provider Mailing Address Detail
| Address | 1720 4th St |
|---|---|
| City | Santa Rosa |
| State | California (CA) |
| Post Code | 954043602 |
| Phone Number | 7075468100 |
| Fax Number | 7075446438 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
| Licence No | 110000344 |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| SUR01428G | CA | -- | |
| 110000344 | CA | STATE OF CA LICENSE |
Post Comment/ Review Below
What is the unique identification code assigned to 4Th Street Laser & Surgery Center Inc by the Centers for Medicare & Medicaid Services?
The 4Th Street Laser & Surgery Center Inc has been issued the NPI (National Provider Identifier) 1902964174. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where 4Th Street Laser & Surgery Center Inc is physically located?
The 4Th Street Laser & Surgery Center Inc is situated at the following address: 1720 4Th St, Santa Rosa, CA 954043602.
What is 4Th Street Laser & Surgery Center Inc's area of expertise and its corresponding taxonomy classification?
The 4Th Street Laser & Surgery Center Inc's field of specialization is Ambulatory Surgical, and it falls under the taxonomy code 261Qa1903X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services issue the 1902964174 to 4Th Street Laser & Surgery Center Inc?
The 4Th Street Laser & Surgery Center Inc received its 1902964174 assignment from the Centers for Medicare & Medicaid Services on 2006-12-04.
When was the information regarding 4Th Street Laser & Surgery Center Inc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to 4Th Street Laser & Surgery Center Inc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2013-01-17.