Healthcare Provider Details
I. General information
NPI: 1821884446
Provider Name (Legal Business Name): GOLDEN SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
435 N ROXBURY DR STE 500
BEVERLY HILLS CA
90210-5027
US
IV. Provider business mailing address
5 HOLLAND STE 101
IRVINE CA
92618-2568
US
V. Phone/Fax
- Phone: 310-288-2174
- Fax:
- Phone: 949-588-2190
- Fax: 949-588-2199
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 | |
VIII. Authorized Official
Name: DR.
NEAL
BLITZ
Title or Position: DIRECTOR
Credential: MD
Phone: 310-288-2174