Provider Demographics
NPI:1962645093
Name:BURTON WAY SURGERY CENTER
Entity Type:Organization
Organization Name:BURTON WAY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:O
Authorized Official - Last Name:RUDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-285-9612
Mailing Address - Street 1:8816 BURTON WAY
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1715
Mailing Address - Country:US
Mailing Address - Phone:310-285-9612
Mailing Address - Fax:310-285-9615
Practice Address - Street 1:8816 BURTON WAY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1715
Practice Address - Country:US
Practice Address - Phone:310-285-9612
Practice Address - Fax:310-285-9615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical