Healthcare Provider Details

I. General information

NPI: 1699170332
Provider Name (Legal Business Name): NOVA SURGICAL INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 VAN NUYS BLVD SUITE 101
VAN NUYS CA
91405
US

IV. Provider business mailing address

6640 VAN NUYS BLVD SUITE 101
VAN NUYS CA
91405
US

V. Phone/Fax

Practice location:
  • Phone: 818-884-5480
  • Fax: 818-884-5490
Mailing address:
  • Phone: 818-884-5480
  • Fax: 818-884-5490

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. VIKRAM SINGH
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 818-884-5480