Healthcare Provider Details
I. General information
NPI: 1003033341
Provider Name (Legal Business Name): CAMDEN SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 N CAMDEN DR 8TH FLOOR
BEVERLY HILLS CA
90210-4532
US
IV. Provider business mailing address
414 N CAMDEN DR 8TH FLOOR
BEVERLY HILLS CA
90210-4532
US
V. Phone/Fax
- Phone: 310-859-3991
- Fax:
- Phone: 310-859-3991
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
MICHAEL
CHURUKIAN
Title or Position: OWNER
Credential: M.D.
Phone: 310-859-3991