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General NPI Number Information
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NPI Number | 1295070399
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Entity Type | Organization
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Legal Business Name | BURBANK SURGERY CENTER, INC
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 2701 W ALAMEDA AVE SUITE 602
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City | BURBANK
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State | CA
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Zip | 91505-4402
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Country | US
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Telephone | 818-846-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 W ALAMEDA AVE SUITE 602
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City | BURBANK
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State | CA
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Zip | 91505-4402
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Country | US
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Telephone | 818-846-1335
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Fax |
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DR. HUSSAM Y ANTOIN
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Credential | M.D.
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Telephone | 818-846-1335
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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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