Provider Demographics
NPI:1033215223
Name:WESTWOOD SURGERY CENTER
Entity Type:Organization
Organization Name:WESTWOOD SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:JASSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-446-4647
Mailing Address - Street 1:10884 SANTA MONICA BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4646
Mailing Address - Country:US
Mailing Address - Phone:310-446-4647
Mailing Address - Fax:310-446-4654
Practice Address - Street 1:10884 SANTA MONICA BLVD STE 402
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4646
Practice Address - Country:US
Practice Address - Phone:310-446-4647
Practice Address - Fax:310-446-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051714Medicare ID - Type Unspecified