MEDICARE: BRIGHTON 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1982740734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTON SURGICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	2080 CENTURY PARK E STE 1206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2015
Country	:	US
Telephone Number	:	310-282-0525
Fax Number	:	310-201-0662

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E STE 1206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2015
Country	:	US
Telephone Number	:	310-282-0525
Fax Number	:	310-201-0662

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. NICHOLAS KARYOTAKIS
Credential	:	MD
Telephone Number	:	310-282-0525

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	03/05/2024

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