Healthcare Provider Details

I. General information

NPI: 1912563685
Provider Name (Legal Business Name): DELUXE SURGERY CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 01/29/2021
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W ALAMEDA AVE STE 602
BURBANK CA
91505-4411
US

IV. Provider business mailing address

2701 W ALAMEDA AVE STE 602
BURBANK CA
91505-4411
US

V. Phone/Fax

Practice location:
  • Phone: 818-983-1145
  • Fax:
Mailing address:
  • Phone: 818-983-1145
  • 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: MRS. KRISTINE ARUTYUNYAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-861-7149