Provider Demographics
NPI: | 1770171852 |
---|---|
Name: | SURGERY CENTER OF SANTA MONICA LLC |
Entity type: | Organization |
Organization Name: | SURGERY CENTER OF SANTA MONICA LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | DOCTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ZARRABI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 310-584-9990 |
Mailing Address - Street 1: | 150 S RODEO DR STE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | BEVERLY HILLS |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90212-2440 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-584-9990 |
Mailing Address - Fax: | 310-584-9992 |
Practice Address - Street 1: | 150 S RODEO DR STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | BEVERLY HILLS |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90212-2440 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-584-9990 |
Practice Address - Fax: | 310-584-9992 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-01-05 |
Last Update Date: | 2024-06-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical | Group - Single Specialty |