Provider Demographics
NPI:1144673526
Name:MURRIETA VALLEY SURGERY CENTER, INC.A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:MURRIETA VALLEY SURGERY CENTER, INC.A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TITO
Authorized Official - Middle Name:F
Authorized Official - Last Name:GORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-698-3000
Mailing Address - Street 1:36320 INLAND VALLEY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7512
Mailing Address - Country:US
Mailing Address - Phone:951-228-2817
Mailing Address - Fax:
Practice Address - Street 1:36320 INLAND VALLEY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7512
Practice Address - Country:US
Practice Address - Phone:951-228-2817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical