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NPI Code Detail

MEDICARE: LAKEWOOD AMBULATORY SURGICAL CENTER, INC.

MEDICARE: LAKEWOOD AMBULATORY SURGICAL CENTER, INC.
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1679117782
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEWOOD AMBULATORY SURGICAL CENTER, INC.
Provider Business Mailing Address
First Line : 16506 LAKEWOOD BLVD STE 200
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-5165
Country : US
Telephone Number : 562-867-5300
Fax Number : 562-867-8666
Provider Business Practice Location Address
First Line : 16506 LAKEWOOD BLVD STE 200
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-5165
Country : US
Telephone Number : 562-867-5300
Fax Number : 562-867-8666
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. ARVIND MEHTA
Credential : MD
Telephone Number : 562-867-5300
Provider Enumeration Date : 10/31/2019
Last Update Date : 10/31/2019

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