Provider Demographics
NPI:1518502699
Name:CS SURGERY CENTER
Entity Type:Organization
Organization Name:CS SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-832-3992
Mailing Address - Street 1:11645 WILSHIRE BLVD STE 987
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6814
Mailing Address - Country:US
Mailing Address - Phone:424-832-3992
Mailing Address - Fax:424-832-7076
Practice Address - Street 1:11645 WILSHIRE BLVD STE 987
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6814
Practice Address - Country:US
Practice Address - Phone:424-832-3992
Practice Address - Fax:424-832-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical