Provider Demographics
NPI:1891407425
Name:PEDIATRIC SURGERY SOLUTIONS INC
Entity Type:Organization
Organization Name:PEDIATRIC SURGERY SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-372-8500
Mailing Address - Street 1:PO BOX 6287
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90264-6287
Mailing Address - Country:US
Mailing Address - Phone:805-372-8500
Mailing Address - Fax:
Practice Address - Street 1:2190 LYNN RD STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8020
Practice Address - Country:US
Practice Address - Phone:805-372-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Single Specialty