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General NPI Number Information
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NPI Number | 1427487982
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Entity Type | Organization
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Legal Business Name | SAMARITAN TOWER SURGERY CENTER, LLC
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD SUITE 1000
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City | LOS ANGELES
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State | CA
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Zip | 90017-3901
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Country | US
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Telephone | 213-977-1077
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Fax | 213-977-1073
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Provider Business Mailing Address
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Address Line | 1127 WILSHIRE BLVD SUITE 1000
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City | LOS ANGELES
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State | CA
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Zip | 90017-3901
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Country | US
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Telephone | 213-977-1077
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Fax | 213-977-1073
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Authorized Official
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Title or Position | CEO
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Name | DR. JORGE DAMIAN MINOR
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Credential | M.D
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Telephone | 213-977-1077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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