Provider Demographics
NPI:1679642847
Name:ALMONT AMBULITORY SURGERY CENTER
Entity Type:Organization
Organization Name:ALMONT AMBULITORY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:OMIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-273-8885
Mailing Address - Street 1:9001 WILSHIRE BLVD
Mailing Address - Street 2:STE. 106
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1838
Mailing Address - Country:US
Mailing Address - Phone:310-273-8885
Mailing Address - Fax:310-273-8662
Practice Address - Street 1:9001 WILSHIRE BLVD
Practice Address - Street 2:STE. 106
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1838
Practice Address - Country:US
Practice Address - Phone:310-273-8885
Practice Address - Fax:310-273-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84519261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical