Provider Demographics
NPI:1801346309
Name:CENTURION SURGICAL CENTER, INC
Entity type:Organization
Organization Name:CENTURION SURGICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAPIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-597-1278
Mailing Address - Street 1:30200 AGOURA RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-5434
Mailing Address - Country:US
Mailing Address - Phone:818-597-1278
Mailing Address - Fax:818-597-1287
Practice Address - Street 1:30200 AGOURA RD
Practice Address - Street 2:SUITE 160
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-5434
Practice Address - Country:US
Practice Address - Phone:818-597-1278
Practice Address - Fax:818-597-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical