MEDICARE: STARPOINT SURGERY CENTER - STUDIO CITY LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	930000905	CA

General Provider Information

NPI Number	:	1144390725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARPOINT SURGERY CENTER - STUDIO CITY LP

Provider Business Mailing Address
First Line	:	19000 MACARTHUR BLVD
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92612-1438
Country	:	US
Telephone Number	:	949-705-5105
Fax Number	:

Provider Business Practice Location Address
First Line	:	12660 RIVERSIDE DR
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91607-3429
Country	:	US
Telephone Number	:	818-623-5310
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/AUTHORIZED OFFICIAL
Name	:	MR. ERIC D. FRIEDLANDER
Credential	:
Telephone Number	:	949-705-5105

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	10/13/2014

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