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General NPI Number Information
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NPI Number | 1205083607
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Entity Type | Organization
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Legal Business Name | SANTA MONICA SURGICAL CENTER LLC
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 2825 SANTA MONICA BLVD SUITE 100B
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City | SANTA MONICA
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State | CA
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Zip | 90404-2429
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Country | US
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Telephone | 888-360-3522
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 SANTA MONICA BLVD SUITE 100B
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City | SANTA MONICA
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State | CA
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Zip | 90404-2429
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Country | US
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Telephone | 888-360-3522
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ZCHODAE STROM
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Credential |
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Telephone | 888-360-3522
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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 | 141835
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License Number State | CA
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