MEDICARE: THE CENTER FOR AMBULATORY SURGICAL TREATMENT, 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	930000985	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00114687	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AS1581	OTHER	CA	BLUE CROSS

General Provider Information

NPI Number	:	1932106358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTER FOR AMBULATORY SURGICAL TREATMENT, LP

Provider Business Mailing Address
First Line	:	1090 GLENDON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-2908
Country	:	US
Telephone Number	:	310-209-6500
Fax Number	:	310-209-6225

Provider Business Practice Location Address
First Line	:	1090 GLENDON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-2908
Country	:	US
Telephone Number	:	310-209-6500
Fax Number	:	310-209-6225

Authorized Official
Title or Position	:	OFFICER, AUTHORIZED OFFICIAL
Name	:	KATHERINE L. REED
Credential	:
Telephone Number	:	972-763-3859

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/30/2014

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Directions to “THE CENTER FOR AMBULATORY SURGICAL TREATMENT, LP ” Practice Location

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