Healthcare Provider Details

I. General information

NPI: 1346531522
Provider Name (Legal Business Name): LB SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 LONG BEACH BLVD STE 150
LONG BEACH CA
90807-2011
US

IV. Provider business mailing address

4300 LONG BEACH BLVD STE 150
LONG BEACH CA
90807-2011
US

V. Phone/Fax

Practice location:
  • Phone: 831-588-7296
  • Fax: 661-873-7315
Mailing address:
  • Phone: 831-588-7296
  • Fax: 661-873-7315

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. LEE JAMES MAREK
Title or Position: OWNER
Credential: D.P.M
Phone: 831-588-7296