Healthcare Provider Details
I. General information
NPI: 1932478294
Provider Name (Legal Business Name): SINAI SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2011
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
99 N LA CIENEGA BLVD STE 303
BEVERLY HILLS CA
90211-2283
US
IV. Provider business mailing address
99 N LA CIENEGA BLVD STE 303
BEVERLY HILLS CA
90211-2283
US
V. Phone/Fax
- Phone: 800-529-3962
- Fax: 424-456-9413
- Phone: 800-529-3962
- Fax: 424-456-9413
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: MR.
JEFF
ROBERTSON
Title or Position: CEO - ADMINISTRATOR
Credential:
Phone: 800-529-3962