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General NPI Number Information
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NPI Number | 1518177534
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Entity Type | Organization
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Legal Business Name | HERNIA CENTER OF SOUTHERN CALIFORNIA, INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 31 WEST BELLEVUE DRIVE
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City | PASADENA
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State | CA
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Zip | 91105
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Country | US
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Telephone | 626-584-6116
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Fax | 626-584-7886
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Provider Business Mailing Address
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Address Line | 31 WEST BELLEVUE DRIVE
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City | PASADENA
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State | CA
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Zip | 91105
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Country | US
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Telephone | 626-584-6116
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Fax | 626-584-7886
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Authorized Official
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Title or Position | CEO, HERNIA CENTER OF SOUTHERN CALI
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Name | DR. DAVID MARK ALBIN
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Credential | M.D.
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Telephone | 626-584-6116
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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 | A39342
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License Number State | CA
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