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NPI Code Detail

MEDICARE: KINETIX SURGERY CENTER, INC

MEDICARE: KINETIX SURGERY CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1548609472
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINETIX SURGERY CENTER, INC
Provider Business Mailing Address
First Line : 5651 SEPULVEDA BLVD
Second Line : SUITE 101
City : SHERMAN OAKS
State : CA
Zip : 91411-2916
Country : US
Telephone Number : 818-788-2400
Fax Number :
Provider Business Practice Location Address
First Line : 5651 SEPULVEDA BLVD
Second Line : SUITE 101
City : SHERMAN OAKS
State : CA
Zip : 91411-2916
Country : US
Telephone Number : 818-788-2400
Fax Number :
Authorized Official
Title or Position : OWNER/MEDICAL DIRECTOR
Name : DR. EDWIN HARONIAN
Credential : M.D.
Telephone Number : 818-205-9388
Provider Enumeration Date : 06/25/2013
Last Update Date : 06/25/2013

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Directions to “KINETIX SURGERY CENTER, INC ” Practice Location

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