Healthcare Provider Details

I. General information

NPI: 1124411848
Provider Name (Legal Business Name): VALLEY SURGERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16917 ENADIA WAY
VAN NUYS CA
91406-3602
US

IV. Provider business mailing address

16917 ENADIA WAY
VAN NUYS CA
91406-3602
US

V. Phone/Fax

Practice location:
  • Phone: 818-401-1010
  • Fax:
Mailing address:
  • Phone: 818-401-1010
  • 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: IHAB AZIZ
Title or Position: PRESIDENT
Credential:
Phone: 818-401-1010