Provider Demographics
NPI:1144531377
Name:KINGS RIVER SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:KINGS RIVER SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CSISZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-587-0330
Mailing Address - Street 1:125 MALL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5786
Mailing Address - Country:US
Mailing Address - Phone:559-836-8099
Mailing Address - Fax:866-608-3486
Practice Address - Street 1:125 MALL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5786
Practice Address - Country:US
Practice Address - Phone:559-836-8099
Practice Address - Fax:866-608-3486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical