Provider Demographics
NPI:1801419288
Name:BIONIC SURGERY CENTER INC
Entity Type:Organization
Organization Name:BIONIC SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:FARDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-578-5125
Mailing Address - Street 1:5620 WILBUR AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1311
Mailing Address - Country:US
Mailing Address - Phone:818-578-5125
Mailing Address - Fax:818-578-6039
Practice Address - Street 1:5620 WILBUR AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1311
Practice Address - Country:US
Practice Address - Phone:818-578-5125
Practice Address - Fax:818-578-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
648832OtherJOINT COMMISSION