Healthcare Provider Details

I. General information

NPI: 1164909578
Provider Name (Legal Business Name): CENTER FOR SPECIALTY SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 ATLANTIC AVE STE 101
LONG BEACH CA
90807-2260
US

IV. Provider business mailing address

369 S DOHENY DR STE 155
BEVERLY HILLS CA
90211-3508
US

V. Phone/Fax

Practice location:
  • Phone: 562-984-2038
  • Fax:
Mailing address:
  • Phone: 562-422-5400
  • 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. ARTIS WOODWARD
Title or Position: OWNER
Credential: A40488
Phone: 562-422-5400