Provider Demographics
NPI:1447390448
Name:DOWNTOWN LA AMBULATORY SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:DOWNTOWN LA AMBULATORY SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-366-0474
Mailing Address - Street 1:420 E 3RD ST
Mailing Address - Street 2:SUITE 604
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1644
Mailing Address - Country:US
Mailing Address - Phone:213-626-3330
Mailing Address - Fax:213-626-3335
Practice Address - Street 1:420 E 3RD STREET SUITE #604
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1644
Practice Address - Country:US
Practice Address - Phone:213-626-3330
Practice Address - Fax:213-626-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051809OtherMEDICARE PTAN
CAS051809OtherMEDICARE PTAN