PACIFIC SURGICAL SUITE LLC NPI 1518452531

NPI Information

NPI: 1518452531
Provider Name: PACIFIC SURGICAL SUITE, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D2153169

Address:
558 SAINT CHARLES DR STE 200
THOUSAND OAKS, CA
ZIP 91360
Phone: (805) 379-2322
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PACIFIC SURGICAL SUITE, LLC is an ambulatory surgical clinic center in Thousand Oaks, CA. PACIFIC SURGICAL SUITE, LLC NPI is 1518452531. The provider is registered as an organization entity type.

The provider's business location address is:

558 SAINT CHARLES DR STE 200
THOUSAND OAKS, CA
ZIP 91360-968
Phone: (805) 379-2322

The provider's authorized official is Earl Gomberg .
The authorized official title is Coo and has the following contact phone number (805) 379-2322.

The CLIA number assigned to this NPI record is 05D2153169 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2018 and was last updated on 7/20/2021.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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