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General NPI Number Information
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NPI Number | 1003129016
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Entity Type | Organization
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Legal Business Name | 9201 SUNSET SURGERY CENTER, INC.
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 9201 W SUNSET BLVD SUITE GF
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City | LOS ANGELES
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State | CA
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Zip | 90069-3701
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Country | US
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Telephone | 310-274-9201
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Fax | 310-274-9202
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Provider Business Mailing Address
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Address Line | 9201 W SUNSET BLVD SUITE GF
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City | LOS ANGELES
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State | CA
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Zip | 90069-3701
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Country | US
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Telephone | 310-274-9201
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Fax | 310-274-9202
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | GARY MOTYKIE
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Credential | M.D.
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Telephone | 310-274-9201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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