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General NPI Number Information
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NPI Number | 1619809563
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Entity Type | Organization
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Legal Business Name | LOS ANGELES SURGICAL CENTER
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 323 N PRAIRIE AVE STE 114
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City | INGLEWOOD
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State | CA
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Zip | 90301-4503
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Country | US
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Telephone | 949-436-5630
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Fax |
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Provider Business Mailing Address
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Address Line | 2549 EASTBLUFF DR STE 337
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3500
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Country | US
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Telephone | 949-436-5630
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JOHN HEWETT
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Credential | MD
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Telephone | 949-394-5018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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