Provider Demographics
NPI:1164909578
Name:CENTER FOR SPECIALTY SURGERY LLC
Entity Type:Organization
Organization Name:CENTER FOR SPECIALTY SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:A40488
Authorized Official - Phone:562-422-5400
Mailing Address - Street 1:369 S DOHENY DR STE 155
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3508
Mailing Address - Country:US
Mailing Address - Phone:562-422-5400
Mailing Address - Fax:
Practice Address - Street 1:4401 ATLANTIC AVE STE 101
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2260
Practice Address - Country:US
Practice Address - Phone:562-984-2038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical