Healthcare Provider Details

I. General information

NPI: 1841883659
Provider Name (Legal Business Name): OXFORD SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N ROXBURY DR STE 205
BEVERLY HILLS CA
90210-5004
US

IV. Provider business mailing address

435 N ROXBURY DR STE 205
BEVERLY HILLS CA
90210-5004
US

V. Phone/Fax

Practice location:
  • Phone: 310-275-2705
  • Fax: 310-275-2701
Mailing address:
  • Phone: 310-275-2705
  • Fax: 310-275-2701

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. MICHAEL K OBENG
Title or Position: OWNER
Credential: MD
Phone: 310-275-2705