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General NPI Number Information
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NPI Number | 1366643751
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Entity Type | Organization
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Legal Business Name | SPECIALTY SURGICAL CENTER OF WESTLAKE VILLAGE, LLC
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 696 HAMPSHIRE ROAD SUITE 100
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-4456
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Country | US
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Telephone | 805-413-7920
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Fax | 805-413-7921
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Provider Business Mailing Address
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Address Line | 696 HAMPSHIRE ROAD SUITE 100
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-413-7920
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Fax | 805-413-7921
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | ERIC BOON
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Credential |
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Telephone | 480-567-0269
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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 | CA
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Taxonomy #2
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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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