Healthcare Provider Details

I. General information

NPI: 1750324893
Provider Name (Legal Business Name): COMPREHENSIVE AMBULATORY SURGICAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11026 VALLEY MALL
EL MONTE CA
91731-2617
US

IV. Provider business mailing address

PO BOX 1709
BEVERLY HILLS CA
90213-1709
US

V. Phone/Fax

Practice location:
  • Phone: 626-443-5938
  • Fax: 626-443-5968
Mailing address:
  • Phone: 213-637-2530
  • Fax: 213-384-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. JUAN CARLOS GARCIA
Title or Position: BUSINESS ACCOUNTS MANAGER
Credential:
Phone: 213-637-2530