Healthcare Provider Details

I. General information

NPI: 1184411886
Provider Name (Legal Business Name): OCULOPLASTIC SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16101 VENTURA BLVD STE 238
ENCINO CA
91436-2513
US

IV. Provider business mailing address

16101 VENTURA BLVD STE 238
ENCINO CA
91436-2513
US

V. Phone/Fax

Practice location:
  • Phone: 310-860-0800
  • Fax:
Mailing address:
  • Phone: 310-860-0800
  • 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. ROBERT LEVINE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 310-860-0800