Provider Demographics
NPI:1790909117
Name:SHARP SURGERY CENTER
Entity Type:Organization
Organization Name:SHARP SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-626-8037
Mailing Address - Street 1:2557 PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7035
Mailing Address - Country:US
Mailing Address - Phone:310-626-8037
Mailing Address - Fax:310-626-8038
Practice Address - Street 1:2557 PACIFIC COAST HIGHWAY
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-626-8037
Practice Address - Fax:310-626-8038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52232261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical