Provider Demographics
NPI:1659885325
Name:GOLDEN SPRINGS SURGICAL CENTER
Entity type:Organization
Organization Name:GOLDEN SPRINGS SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:ULRICH
Authorized Official - Last Name:LEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-344-2822
Mailing Address - Street 1:67555 E PALM CANYON DR STE F117
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-5428
Mailing Address - Country:US
Mailing Address - Phone:760-656-6111
Mailing Address - Fax:760-656-6110
Practice Address - Street 1:67555 E PALM CANYON DR STE F117
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-5428
Practice Address - Country:US
Practice Address - Phone:760-656-6111
Practice Address - Fax:760-656-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80383261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical