Provider Demographics
NPI:1518423672
Name:PACIFIC RITZ SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:PACIFIC RITZ SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-827-5100
Mailing Address - Street 1:16311 VENTURA BLVD STE 570
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4314
Mailing Address - Country:US
Mailing Address - Phone:818-827-5100
Mailing Address - Fax:
Practice Address - Street 1:16311 VENTURA BLVD STE 570
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4314
Practice Address - Country:US
Practice Address - Phone:818-827-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical