Healthcare Provider Details

I. General information

NPI: 1861980690
Provider Name (Legal Business Name): NEW HORIZON SURGICAL INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14624 SHERMAN WAY STE 307
VAN NUYS CA
91405-2288
US

IV. Provider business mailing address

14624 SHERMAN WAY STE 307
VAN NUYS CA
91405-2288
US

V. Phone/Fax

Practice location:
  • Phone: 818-405-0064
  • Fax:
Mailing address:
  • Phone:
  • 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: AKIKUR MOHAMMAD
Title or Position: CFO
Credential:
Phone: 818-922-4779