Provider Demographics
NPI:1669953949
Name:LUXE SURGERY CENTER OF ENCINO LLC
Entity type:Organization
Organization Name:LUXE SURGERY CENTER OF ENCINO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-663-4595
Mailing Address - Street 1:17525 VENTURA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5101
Mailing Address - Country:US
Mailing Address - Phone:818-783-5058
Mailing Address - Fax:818-783-5059
Practice Address - Street 1:17525 VENTURA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5101
Practice Address - Country:US
Practice Address - Phone:818-783-5058
Practice Address - Fax:818-783-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical