Provider Demographics
NPI:1851085245
Name:ASTRO SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:ASTRO SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HRIPSIME
Authorized Official - Middle Name:
Authorized Official - Last Name:AVAGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:747-233-1222
Mailing Address - Street 1:12626 RIVERSIDE DR STE 306
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3477
Mailing Address - Country:US
Mailing Address - Phone:747-233-1222
Mailing Address - Fax:747-233-1939
Practice Address - Street 1:12626 RIVERSIDE DR STE 306
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3477
Practice Address - Country:US
Practice Address - Phone:747-233-1222
Practice Address - Fax:747-233-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical