Basic Information
| Provider Information | |||||||||
| NPI: | 1083382154 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRI-CITY SURGICAL CENTERS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6343 E MAIN ST STE 12 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852058955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808356100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 143 S 63RD STREET | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808356100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2021 | ||||||||
| LastUpdateDate: | 09/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | KAHLON | ||||||||
| AuthorizedOfficialFirstName: | JASKAMAL | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 4808356100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.