Healthcare Provider Details
I. General information
NPI: 1326107178
Provider Name (Legal Business Name): NORTH REXFORD CENTER FOR AMBULATORY SURG.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/07/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9301 WILSHIRE BLVD SUITE. 301
BEVERLY HILLS CA
90210-5424
US
IV. Provider business mailing address
9601 WILSHIRE BLVD SUITE #1135
BEVERLY HILLS CA
90210-5213
US
V. Phone/Fax
- Phone: 310-273-3647
- Fax: 310-273-5601
- Phone: 310-273-3647
- Fax: 310-273-5601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | A41518 |
| License Number State | CA |
VIII. Authorized Official
Name:
ARMAND
NEWMAN
Title or Position: DIRECTOR
Credential:
Phone: 310-273-3647