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General NPI Number Information
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NPI Number | 1649774977
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Entity Type | Organization
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Legal Business Name | VANGUARD SURGERY CENTER, LLC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 9301 WILSHIRE BLVD STE 100
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-6100
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Country | US
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Telephone | 310-855-3960
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Fax |
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Provider Business Mailing Address
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Address Line | 9301 WILSHIRE BLVD STE 100
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-6100
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Country | US
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Telephone | 310-855-3960
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN, GOVERNING BODY
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Name | DR. PERRY LIU
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Credential | M.D.
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Telephone | 310-855-3960
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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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