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General NPI Number Information
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NPI Number | 1306052014
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST SURGICAL CENTER
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3720 LOMITA BLVD 100
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City | TORRANCE
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State | CA
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Zip | 90505-3884
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Country | US
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Telephone | 310-376-7000
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Fax | 310-373-0319
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Provider Business Mailing Address
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Address Line | 3720 LOMITA BLVD 100
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City | TORRANCE
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State | CA
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Zip | 90505-3884
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Country | US
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Telephone | 310-376-7000
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Fax | 310-373-0319
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RIFAAT DOVER SALEM
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Credential | M.D
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Telephone | 310-376-7000
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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 | G46242
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License Number State | CA
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