Provider Demographics
NPI:1235436817
Name:SUNFLOWER SURGICAL INC
Entity Type:Organization
Organization Name:SUNFLOWER SURGICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLENBOGEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-276-3183
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE 501
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-276-3183
Mailing Address - Fax:310-276-9154
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 501
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-276-3183
Practice Address - Fax:310-276-9154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty