MEDICARE: UNIFIED SURGICAL CENTER LLC

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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1770425274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIFIED SURGICAL CENTER LLC

Provider Business Mailing Address
First Line	:	50 N LA CIENEGA BLVD STE 150
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3143
Country	:	US
Telephone Number	:	424-421-7624
Fax Number	:	310-358-9222

Provider Business Practice Location Address
First Line	:	50 N LA CIENEGA BLVD STE 150
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3143
Country	:	US
Telephone Number	:	424-421-7624
Fax Number	:	310-358-9222

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RUBINA KHACHATRYAN
Credential	:
Telephone Number	:	424-421-7624

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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