Healthcare Provider Details

I. General information

NPI: 1770653313
Provider Name (Legal Business Name): VALENCIA SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25775 MCBEAN PKWY STE. 108
VALENCIA CA
91355-3708
US

IV. Provider business mailing address

9001 WILSHIRE BLVD STE. 106
BEVERLY HILLS CA
90211
US

V. Phone/Fax

Practice location:
  • Phone: 661-753-9673
  • Fax: 661-259-6200
Mailing address:
  • Phone: 661-753-9673
  • Fax: 661-259-6200

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. MICHAEL M OMIDI
Title or Position: OWNER OPERATOR
Credential: M.D.
Phone: 310-273-8885