Provider Demographics
NPI:1356407332
Name:ALAMEDA SURGERY CENTER LP
Entity type:Organization
Organization Name:ALAMEDA SURGERY CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:E
Authorized Official - Last Name:COZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-842-9728
Mailing Address - Street 1:2601 W ALAMEDA AVE
Mailing Address - Street 2:SUITE #312
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4812
Mailing Address - Country:US
Mailing Address - Phone:818-842-9728
Mailing Address - Fax:818-842-4533
Practice Address - Street 1:2601 W ALAMEDA AVE
Practice Address - Street 2:SUITE #312
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4812
Practice Address - Country:US
Practice Address - Phone:818-842-9728
Practice Address - Fax:818-842-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center