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General NPI Number Information
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NPI Number | 1831748482
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Entity Type | Organization
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Legal Business Name | GOLDEN TRIANGLE SURGERY CENTER LLC
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 436 N ROXBURY DR STE 207
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5017
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Country | US
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Telephone | 310-529-9237
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Fax | 626-331-3204
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Provider Business Mailing Address
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Address Line | 436 N ROXBURY DR STE 207
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5017
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Country | US
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Telephone | 310-529-9237
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Fax | 626-331-3204
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Authorized Official
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Title or Position | OWNER
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Name | DR. A.J. KHALIL
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Credential | MD
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Telephone | 310-529-9237
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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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