Provider Demographics
NPI:1891148532
Name:SERRANO SURGERY CENTER, INC
Entity Type:Organization
Organization Name:SERRANO SURGERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROKHSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-418-0199
Mailing Address - Street 1:4220 W 3RD ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3450
Mailing Address - Country:US
Mailing Address - Phone:213-418-0199
Mailing Address - Fax:213-444-3485
Practice Address - Street 1:4220 W 3RD ST
Practice Address - Street 2:SUITE 114
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3450
Practice Address - Country:US
Practice Address - Phone:213-418-0199
Practice Address - Fax:213-444-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical