Healthcare Provider Details

I. General information

NPI: 1952183360
Provider Name (Legal Business Name): FORWARD SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD STE 101B
LONG BEACH CA
90807-3300
US

IV. Provider business mailing address

3711 LONG BEACH BLVD STE 101B
LONG BEACH CA
90807-3300
US

V. Phone/Fax

Practice location:
  • Phone: 562-380-0771
  • Fax:
Mailing address:
  • Phone: 562-380-0771
  • 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: ANDREW DAVID FOSTER
Title or Position: MEDICAL DIRECTOR / SHAREHOLDER
Credential: MD
Phone: 562-380-0771