THIRD STREET SURGERY CENTER LLC NPI 1144370594

NPI Information

THIRD STREET SURGERY CENTER LLC is an ambulatory surgical clinic center in Los Angeles, CA. THIRD STREET SURGERY CENTER LLC NPI is 1144370594. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Third Street Surgery Center Lp.

The provider's business location address is:

420 E 3RD ST STE 110
LOS ANGELES, CA
ZIP 90013-645
Phone: (213) 617-9194

The provider's authorized official is Alex Liu .
The authorized official title is Vice President/medical Director and has the following contact phone number (213) 617-9194.

The CLIA number assigned to this NPI record is 05D0907402 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2007 and was last updated on 11/4/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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