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General NPI Number Information
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NPI Number | 1932153509
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Entity Type | Organization
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Legal Business Name | NOVAMED SURGERY CENTER OF WHITTIER LLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 15141 WHITTIER BLVD SUITE 130
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City | WHITTIER
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State | CA
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Zip | 90603-2145
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Country | US
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Telephone | 562-945-2832
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Fax | 562-945-2174
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Provider Business Mailing Address
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Address Line | 15141 WHITTIER BLVD SUITE 130
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City | WHITTIER
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State | CA
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Zip | 90603-2135
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Country | US
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Telephone | 562-945-2832
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Fax | 562-945-2174
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5954
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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 | 930000917
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License Number State | CA
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