Provider Demographics
NPI:1508060377
Name:OCEAN PARK HEALTH SURGERY CENTER
Entity Type:Organization
Organization Name:OCEAN PARK HEALTH SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHESKI
Authorized Official - Suffix:
Authorized Official - Credentials:M,D
Authorized Official - Phone:310-575-1500
Mailing Address - Street 1:2034 COTNER AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5668
Mailing Address - Country:US
Mailing Address - Phone:310-575-1500
Mailing Address - Fax:
Practice Address - Street 1:2034 COTNER AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5668
Practice Address - Country:US
Practice Address - Phone:310-575-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical