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General NPI Number Information
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NPI Number | 1750324893
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE AMBULATORY SURGICAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11026 VALLEY MALL
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City | EL MONTE
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State | CA
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Zip | 91731-2617
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Country | US
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Telephone | 626-443-5938
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Fax | 626-443-5968
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Provider Business Mailing Address
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Address Line | PO BOX 1709
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-1709
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Country | US
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Telephone | 213-637-2530
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Fax | 213-384-3373
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Authorized Official
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Title or Position | BUSINESS ACCOUNTS MANAGER
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Name | MR. JUAN CARLOS GARCIA
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Credential |
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Telephone | 213-637-2530
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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 | CA
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