Healthcare Provider Details

I. General information

NPI: 1043677578
Provider Name (Legal Business Name): ROXBURY INSTITUTE SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N ROXBURY DR # 410
BEVERLY HILLS CA
90210-4231
US

IV. Provider business mailing address

450 N ROXBURY DR # 410
BEVERLY HILLS CA
90210-4231
US

V. Phone/Fax

Practice location:
  • Phone: 424-394-1610
  • Fax: 424-394-1628
Mailing address:
  • Phone: 424-394-1610
  • Fax: 424-394-1628

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. DAVID AMRON
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 424-394-1610