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General NPI Number Information
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NPI Number | 1255805545
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Entity Type | Organization
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Legal Business Name | AFFILIATED SURGEONS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/20/2019
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Last Update Date | 01/20/2019
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Provider Practice Location Address
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Address Line | 2802 PACIFIC COAST HWY
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City | TORRANCE
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State | CA
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Zip | 90505-6702
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Country | US
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Telephone | 310-325-1644
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Fax |
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Provider Business Mailing Address
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Address Line | 26893 BOUQUET CANYON RD STE 217
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City | SANTA CLARITA
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State | CA
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Zip | 91350-3500
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Country | US
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Telephone | 805-481-3685
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | JANA GROSCOST
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Credential |
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Telephone | 805-481-3685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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