Provider Demographics
NPI:1689695629
Name:SURGICAL INSTITUTE OF CALIFORNIA
Entity Type:Organization
Organization Name:SURGICAL INSTITUTE OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYOUSH
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SAADAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-247-9090
Mailing Address - Street 1:311 N ROBERTSON BLVD # 240
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1705
Mailing Address - Country:US
Mailing Address - Phone:310-247-9090
Mailing Address - Fax:310-247-9080
Practice Address - Street 1:17203 VENTURA BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4054
Practice Address - Country:US
Practice Address - Phone:818-784-9200
Practice Address - Fax:310-247-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX I.D.