Healthcare Provider Details
I. General information
NPI: 1154880573
Provider Name (Legal Business Name): XCELL SURGERY CENTER 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2019
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
32144 AGOURA RD STE 200
WESTLAKE VILLAGE CA
91361-4031
US
IV. Provider business mailing address
PO BOX 3129
TORRANCE CA
90510-3129
US
V. Phone/Fax
- Phone: 805-601-7772
- Fax: 805-601-7773
- Phone: 310-792-3914
- Fax: 855-898-4055
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
APOSTLE
Title or Position: MEMBER
Credential: DO
Phone: 310-892-3902