Healthcare Provider Details

I. General information

NPI: 1669023172
Provider Name (Legal Business Name): LOS ANGELES MINIMALLY INVASIVE SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 WILSHIRE BLVD STE 215
BEVERLY HILLS CA
90211-1951
US

IV. Provider business mailing address

8929 WILSHIRE BLVD STE 215
BEVERLY HILLS CA
90211-1951
US

V. Phone/Fax

Practice location:
  • Phone: 424-522-3922
  • Fax:
Mailing address:
  • Phone: 424-522-3922
  • Fax:

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. GEORGE RAPPARD
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 424-522-3922