Provider Demographics
NPI:1649893934
Name:SIMI VALLEY SURGERY CENTER INC
Entity type:Organization
Organization Name:SIMI VALLEY SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEBAMBO
Authorized Official - Middle Name:
Authorized Official - Last Name:OJURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-674-0144
Mailing Address - Street 1:8110 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3119
Mailing Address - Country:US
Mailing Address - Phone:310-674-0144
Mailing Address - Fax:310-693-9845
Practice Address - Street 1:3605 ALAMO ST STE 102
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2186
Practice Address - Country:US
Practice Address - Phone:310-674-0144
Practice Address - Fax:310-693-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical