Healthcare Provider Details

I. General information

NPI: 1306139894
Provider Name (Legal Business Name): SMART SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E HUNTINGTON DR
ARCADIA CA
91006-3212
US

IV. Provider business mailing address

131 E HUNTINGTON DR
ARCADIA CA
91006-3212
US

V. Phone/Fax

Practice location:
  • Phone: 626-447-1133
  • Fax: 626-445-5115
Mailing address:
  • Phone: 626-447-1133
  • Fax: 626-445-5115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA37952C
License Number StateCA

VIII. Authorized Official

Name: DR. EDUARDO ERNESTO ANGUIZOLA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 626-447-1133