Provider Demographics
NPI:1447215850
Name:SAXON SURGICAL CENTER INC
Entity Type:Organization
Organization Name:SAXON SURGICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-241-0151
Mailing Address - Street 1:430 EAST AVENIDA DE LOS ARBOLES
Mailing Address - Street 2:SUITE 101
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:805-241-0151
Mailing Address - Fax:805-241-0161
Practice Address - Street 1:430 EAST AVENIDA DE LOS ARBOLES
Practice Address - Street 2:SUITE 101
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-241-0151
Practice Address - Fax:805-241-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000564261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASUR01544FMedicaid
CA050000564OtherDEPT OF HEALTH SERVICES