Provider Demographics
NPI:1831748482
Name:GOLDEN TRIANGLE SURGERY CENTER LLC
Entity type:Organization
Organization Name:GOLDEN TRIANGLE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:A.J.
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-529-9237
Mailing Address - Street 1:436 N ROXBURY DR STE 207
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5017
Mailing Address - Country:US
Mailing Address - Phone:310-529-9237
Mailing Address - Fax:626-331-3204
Practice Address - Street 1:436 N ROXBURY DR STE 207
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5017
Practice Address - Country:US
Practice Address - Phone:310-529-9237
Practice Address - Fax:626-331-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical