Provider Demographics
NPI:1144090390
Name:CALLISTA SURGERY CENTER, LLC
Entity type:Organization
Organization Name:CALLISTA SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-357-9050
Mailing Address - Street 1:370 N WIGET LN STE 250
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2454
Mailing Address - Country:US
Mailing Address - Phone:925-357-9050
Mailing Address - Fax:
Practice Address - Street 1:355 LENNON LN STE 275
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2475
Practice Address - Country:US
Practice Address - Phone:925-357-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical