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General NPI Number Information
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NPI Number | 1871838953
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Entity Type | Organization
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Legal Business Name | DOCTORS AND SURGEONS OF LOS ANGELES
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 3425 FIRESTONE BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-3029
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Country | US
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Telephone | 323-567-2637
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Fax | 714-644-8439
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Provider Business Mailing Address
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Address Line | 3425 FIRESTONE BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-3029
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Country | US
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Telephone | 323-567-2637
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Fax | 714-644-8439
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Authorized Official
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Title or Position | OWNER
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Name | GUSTAVO GUTIERREZ
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Credential | CRNA
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Telephone | 714-282-2222
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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 | 016332
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License Number State | CA
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