Provider Demographics
NPI:1770653313
Name:VALENCIA SURGICAL CENTER
Entity Type:Organization
Organization Name:VALENCIA SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
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
Mailing Address - Country:US
Mailing Address - Phone:661-753-9673
Mailing Address - Fax:661-259-6200
Practice Address - Street 1:25775 MCBEAN PKWY
Practice Address - Street 2:STE. 108
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3708
Practice Address - Country:US
Practice Address - Phone:661-753-9673
Practice Address - Fax:661-259-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical