Provider Demographics
NPI:1205220944
Name:ROXBURY SURGICAL INSTITUTE
Entity Type:Organization
Organization Name:ROXBURY SURGICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEJAL
Authorized Official - Middle Name:MUKUND
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-652-8801
Mailing Address - Street 1:435 N ROXBURY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5003
Mailing Address - Country:US
Mailing Address - Phone:424-652-8801
Mailing Address - Fax:310-362-0319
Practice Address - Street 1:435 N ROXBURY DR STE 106
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5003
Practice Address - Country:US
Practice Address - Phone:424-652-8801
Practice Address - Fax:310-362-0319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical