Healthcare Provider Details

I. General information

NPI: 1679117782
Provider Name (Legal Business Name): LAKEWOOD AMBULATORY SURGICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16506 LAKEWOOD BLVD STE 200
BELLFLOWER CA
90706-5165
US

IV. Provider business mailing address

16506 LAKEWOOD BLVD STE 200
BELLFLOWER CA
90706-5165
US

V. Phone/Fax

Practice location:
  • Phone: 562-867-5300
  • Fax: 562-867-8666
Mailing address:
  • Phone: 562-867-5300
  • Fax: 562-867-8666

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: DR. ARVIND MEHTA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 562-867-5300