Provider Demographics
NPI:1689831760
Name:REXFORD SURGICAL INSTITUTE, INC.
Entity Type:Organization
Organization Name:REXFORD SURGICAL INSTITUTE, INC.
Other - Org Name:AVOSANT SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GRISELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-274-3484
Mailing Address - Street 1:9301 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5424
Mailing Address - Country:US
Mailing Address - Phone:310-274-3484
Mailing Address - Fax:310-274-3482
Practice Address - Street 1:9301 WILSHIRE BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5424
Practice Address - Country:US
Practice Address - Phone:310-274-3484
Practice Address - Fax:310-274-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG076581OtherPROVIDER MEDICAL LICENCE
CAFG0546450OtherDEA