Provider Demographics
NPI:1699855213
Name:SANTA MONICA SURGICAL PARTNERS LLC
Entity Type:Organization
Organization Name:SANTA MONICA SURGICAL PARTNERS LLC
Other - Org Name:SURGERY CENTER OF THE PACIFIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROYSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-576-7267
Mailing Address - Street 1:2121 WILSHIRE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5742
Mailing Address - Country:US
Mailing Address - Phone:310-576-7267
Mailing Address - Fax:855-898-4055
Practice Address - Street 1:2121 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5720
Practice Address - Country:US
Practice Address - Phone:310-576-7267
Practice Address - Fax:310-828-8626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PENDING261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical