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General NPI Number Information
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NPI Number | 1649729120
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Entity Type | Organization
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Legal Business Name | CARMENTA SURGICAL CENTER
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 23679 CALABASAS RD SUITE 415
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City | CALABASAS
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State | CA
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Zip | 91302-1502
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Country | US
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Telephone | 310-795-4488
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Fax |
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Provider Business Mailing Address
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Address Line | 23679 CALABASAS RD SUITE 415
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City | CALABASAS
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State | CA
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Zip | 91302-1502
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Country | US
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Telephone | 310-795-4488
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ADAM ADAIR
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Credential |
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Telephone | 310-795-4488
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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 |
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