Healthcare Provider Details

I. General information

NPI: 1457773442
Provider Name (Legal Business Name): VISTA OUTPATIENT SURGERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 S BUENA VISTA ST # 200
BURBANK CA
91505-4503
US

IV. Provider business mailing address

116 S BUENA VISTA ST # 200
BURBANK CA
91505-4503
US

V. Phone/Fax

Practice location:
  • Phone: 747-477-1018
  • Fax: 818-514-2699
Mailing address:
  • Phone: 747-477-1018
  • 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. ARMEN VARTANY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 747-477-1018