Provider Demographics
NPI:1821207739
Name:WOMENS' HEALTH SURGICAL CENTER
Entity Type:Organization
Organization Name:WOMENS' HEALTH SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RIFAAT
Authorized Official - Middle Name:DOVER
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-376-7000
Mailing Address - Street 1:3720 LOMITA BLVD
Mailing Address - Street 2:#210
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3884
Mailing Address - Country:US
Mailing Address - Phone:310-376-7000
Mailing Address - Fax:310-373-0319
Practice Address - Street 1:3720 LOMITA BLVD
Practice Address - Street 2:#210
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3884
Practice Address - Country:US
Practice Address - Phone:310-376-7000
Practice Address - Fax:310-373-0319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMENS HEALTH SURGICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-21
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46242261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA007783OtherBLUE CROSS
CAZZZH1964COtherBLUE SHIELD
CAA92632Medicare UPIN