Provider Demographics
NPI:1376744888
Name:AALPHA SURGICAL CENTER INC
Entity Type:Organization
Organization Name:AALPHA SURGICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAYEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-204-4189
Mailing Address - Street 1:3831 HUGHES AVE
Mailing Address - Street 2:SUITE 512
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2751
Mailing Address - Country:US
Mailing Address - Phone:310-204-4189
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE
Practice Address - Street 2:SUITE 512
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2751
Practice Address - Country:US
Practice Address - Phone:310-204-4189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49693261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051654Medicare ID - Type UnspecifiedPROVIDER ID NUMBER