Healthcare Provider Details

I. General information

NPI: 1548104524
Provider Name (Legal Business Name): THE SURGERY GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 04/18/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16133 VENTURA BLVD STE 160
ENCINO CA
91436-2403
US

IV. Provider business mailing address

16133 VENTURA BLVD STE 160
ENCINO CA
91436-2403
US

V. Phone/Fax

Practice location:
  • Phone: 888-389-7484
  • Fax: 888-389-7484
Mailing address:
  • Phone: 888-389-7484
  • Fax: 888-389-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER DUVALL
Title or Position: DIRECTOR
Credential: MD
Phone: 888-389-7484