Provider Demographics
NPI:1730514027
Name:KY ADVANCED SURGICAL CENTER INC
Entity type:Organization
Organization Name:KY ADVANCED SURGICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-435-1757
Mailing Address - Street 1:3796 N FRESNO ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-5500
Mailing Address - Country:US
Mailing Address - Phone:559-221-9905
Mailing Address - Fax:559-221-9908
Practice Address - Street 1:3796 N FRESNO ST
Practice Address - Street 2:103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5500
Practice Address - Country:US
Practice Address - Phone:559-221-9905
Practice Address - Fax:559-221-9908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10743261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical