Provider Demographics
NPI:1417253253
Name:TRADE CENTER OUTPATIENT SURGERY, INC
Entity Type:Organization
Organization Name:TRADE CENTER OUTPATIENT SURGERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:SABOONIE
Authorized Official - Last Name:ALAPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:661-265-7000
Mailing Address - Street 1:PO BOX 5308
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-5308
Mailing Address - Country:US
Mailing Address - Phone:661-265-7000
Mailing Address - Fax:661-265-7070
Practice Address - Street 1:38925 TRADE CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3653
Practice Address - Country:US
Practice Address - Phone:661-265-7000
Practice Address - Fax:661-265-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6836207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6592300001Medicare NSC