Provider Demographics
NPI:1851595805
Name:WESTSIDE SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:WESTSIDE SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIMAFRANCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-295-5636
Mailing Address - Street 1:ST. FRANCIS MEDICAL PLAZA
Mailing Address - Street 2:91-2139 FT. WEAVER ROAD, SUITE 310
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706
Mailing Address - Country:US
Mailing Address - Phone:808-295-5636
Mailing Address - Fax:
Practice Address - Street 1:ST. FRANCIS MEDICAL PLAZA
Practice Address - Street 2:91-2139 FT. WEAVER ROAD, SUITE 310
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706
Practice Address - Country:US
Practice Address - Phone:808-295-5636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-14318208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty