Healthcare Provider Details

I. General information

NPI: 1366394108
Provider Name (Legal Business Name): AXIS SURGERY CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S VIRGIL AVE STE 206
LOS ANGELES CA
90020-1443
US

IV. Provider business mailing address

5832 BEACH BLVD UNIT 210
BUENA PARK CA
90621-5501
US

V. Phone/Fax

Practice location:
  • Phone: 213-622-0021
  • Fax:
Mailing address:
  • Phone:
  • 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: PHILLIP LIM
Title or Position: CEO
Credential: DO
Phone: 213-622-0021