Provider Demographics
NPI:1033677844
Name:SOCAL SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:SOCAL SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGROUDI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:805-742-4900
Mailing Address - Street 1:1901 SOLAR DR STE 110
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2642
Mailing Address - Country:US
Mailing Address - Phone:805-742-4900
Mailing Address - Fax:
Practice Address - Street 1:1901 SOLAR DR STE 110
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2642
Practice Address - Country:US
Practice Address - Phone:213-359-3050
Practice Address - Fax:213-359-3050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical