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General NPI Number Information
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NPI Number | 1790834612
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Entity Type | Organization
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Legal Business Name | SHERMAN OAKS SURGERY CENTER INC. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 5170 SEPULVEDA BLVD #140
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1171
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Country | US
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Telephone | 818-728-4833
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Fax |
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Provider Business Mailing Address
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Address Line | 5170 SEPULVEDA BLVD STE 140
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City | SHERMAN OAKS
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State | CA
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Zip | 91403
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Country | US
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Telephone | 818-995-8702
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Fax | 818-995-8703
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. AZIZ H BERJIS
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Credential | DPM
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Telephone | 818-995-8702
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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 | 9300946
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 975-4776372
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License Number State | CA
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