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General NPI Number Information
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NPI Number | 1982180782
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Entity Type | Organization
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Legal Business Name | ROBERTSON SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/14/2018
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 822 S ROBERTSON BLVD STE 100B
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City | LOS ANGELES
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State | CA
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Zip | 90035-1613
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Country | US
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Telephone | 310-651-6937
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Fax | 310-651-6937
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Provider Business Mailing Address
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Address Line | 822 S ROBERTSON BLVD STE 100B
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City | LOS ANGELES
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State | CA
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Zip | 90035-1613
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Country | US
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Telephone | 310-651-6937
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Fax | 310-651-6937
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | JOSEPH ENAYATI
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Credential | DO
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Telephone | 310-651-6937
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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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