Healthcare Provider Details

I. General information

NPI: 1649893934
Provider Name (Legal Business Name): SIMI VALLEY SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 ALAMO ST STE 102
SIMI VALLEY CA
93063-2186
US

IV. Provider business mailing address

8110 AIRPORT BLVD
LOS ANGELES CA
90045-3119
US

V. Phone/Fax

Practice location:
  • Phone: 310-674-0144
  • Fax: 310-693-9845
Mailing address:
  • Phone: 310-674-0144
  • Fax: 310-693-9845

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. ADEBAMBO OJURI
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 310-674-0144