Provider Demographics
NPI:1427369503
Name:MOUNT SINAI SURGERY CENTER LLC
Entity Type:Organization
Organization Name:MOUNT SINAI SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHABATIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-470-8446
Mailing Address - Street 1:18425 BURBANK BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2806
Mailing Address - Country:US
Mailing Address - Phone:310-470-8446
Mailing Address - Fax:310-470-4250
Practice Address - Street 1:18425 BURBANK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2806
Practice Address - Country:US
Practice Address - Phone:310-470-8446
Practice Address - Fax:310-470-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical