Healthcare Provider Details

I. General information

NPI: 1801346309
Provider Name (Legal Business Name): CENTURION SURGICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30200 AGOURA RD SUITE 160
AGOURA HILLS CA
91301-5434
US

IV. Provider business mailing address

30200 AGOURA RD SUITE 160
AGOURA HILLS CA
91301-5434
US

V. Phone/Fax

Practice location:
  • Phone: 818-597-1278
  • Fax: 818-597-1287
Mailing address:
  • Phone: 818-597-1278
  • Fax: 818-597-1287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAPIL K MOZA
Title or Position: CEO/MEDICAL DIRECTOR
Credential: M.D.
Phone: 818-597-1278