PHYSICIANS TERRACE SURGERY CENTER, LLC NPI 1023293008

Clinic/Center (Ambulatory Surgical) in Glendale, CA

NPI 1023293008 Organization Clinic/Center Ambulatory Surgical CLIA Number 05D2074368 CLIA Certificate of Waiver

About PHYSICIANS TERRACE SURGERY CENTER, LLC

Physicians Terrace Surgery Center, Llc is a provider established in Glendale, California specializing in clinic/center (ambulatory surgical) . The NPI number of Physicians Terrace Surgery Center, Llc is 1023293008 and was assigned on January 2008. The practitioner's primary taxonomy code is 261QA1903X with license number TO BE APPLIED FOR (CA). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Dr. Glenn Silcott M.d. (Administrator)

The CLIA number of Physicians Terrace Surgery Center, Llc is 05D2074368 registered as a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Physicians Terrace Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1023293008

Provider NamePHYSICIANS TERRACE SURGERY CENTER, LLC
Provider Location Address1500 E. CHEVY CHASE DR. SUITE 101 GLENDALE, CA 91206
Provider Mailing Address381B MERRILL AVE SUITE 201A GLENDALE, CA 91206
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-08-2008
Last Update Date01-08-2008


Primary Taxonomy

Taxonomy Code261QA1903X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAmbulatory Surgical
License No.TO BE APPLIED FOR
License StateCA

Business Address

PHYSICIANS TERRACE SURGERY CENTER, LLC
1500 E. CHEVY CHASE DR.
SUITE 101
GLENDALE, CA
ZIP 91206
Phone: (818) 409-3575
Fax: (818) 546-5694

Get Directions


Mailing Address

PHYSICIANS TERRACE SURGERY CENTER, LLC
381B MERRILL AVE
SUITE 201A
GLENDALE, CA
ZIP 91206
Phone: (818) 409-3575
Fax: (818) 546-5694



Authorized Official

Authorized Official NameDR. GLENN SILCOTT M.D.
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(818) 409-3575

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1023293008 is:

CLIA Number05D2074368
Facility TypeAMBULATORY SURGERY CENTER
Certificate TypeCertificate of Waiver

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.