Provider Demographics
NPI:1871827253
Name:BEAUTY PROFESSIONALS SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:BEAUTY PROFESSIONALS SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-952-2000
Mailing Address - Street 1:408 S BEACH BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-1888
Mailing Address - Country:US
Mailing Address - Phone:714-952-2000
Mailing Address - Fax:714-952-4100
Practice Address - Street 1:408 S BEACH BLVD STE 212
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-1888
Practice Address - Country:US
Practice Address - Phone:714-952-2000
Practice Address - Fax:714-952-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABUS2008-00878261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical