Provider Demographics
NPI:1265896559
Name:OPTIMA SURGERY CENTER, LLC
Entity type:Organization
Organization Name:OPTIMA SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAYPEKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-409-0060
Mailing Address - Street 1:1500 S CENTRAL AVE STE 126
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2571
Mailing Address - Country:US
Mailing Address - Phone:818-409-0060
Mailing Address - Fax:818-409-0066
Practice Address - Street 1:1500 S CENTRAL AVE STE 126
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2571
Practice Address - Country:US
Practice Address - Phone:818-409-0060
Practice Address - Fax:818-409-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical