Healthcare Provider Details

I. General information

NPI: 1982740734
Provider Name (Legal Business Name): BRIGHTON SURGICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E STE 1206
LOS ANGELES CA
90067-2015
US

IV. Provider business mailing address

2080 CENTURY PARK E STE 1206
LOS ANGELES CA
90067-2015
US

V. Phone/Fax

Practice location:
  • Phone: 310-282-0525
  • Fax: 310-201-0662
Mailing address:
  • Phone: 310-282-0525
  • Fax: 310-201-0662

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. NICHOLAS KARYOTAKIS
Title or Position: DIRECTOR
Credential: MD
Phone: 310-282-0525