PIVAC ASC LLC NPI 1679010417

NPI Information

  • NPI: 1679010417
  • Provider Name: PIVAC ASC LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 05D2137660
  • Address: 6076 BRISTOL PKWY
    SUITE 108
    CULVER CITY, CA
    ZIP 90230
  • Phone: (310) 348-9604

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NPI Details

PIVAC ASC LLC is an ambulatory surgical clinic center in Culver City, CA. PIVAC ASC LLC NPI is 1679010417. The provider is registered as an organization entity type.

The provider's business location address is:

6076 BRISTOL PKWY
SUITE 108
CULVER CITY, CA
ZIP 90230-600
Phone: (310) 348-9604

The provider's authorized official is Spencer L. Brown .
The authorized official title is Medical Director and has the following contact phone number (310) 348-9604.

The CLIA number assigned to this NPI record is 05D2137660 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist (HCPCS:36902)
  • Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist (HCPCS:36903)
  • Insertion of needle and/or tube into hemodialysis circuit with review by radiologist (HCPCS:36901)
  • Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube (HCPCS:36905)
  • Removal of tunneled central venous tube (HCPCS:36589)
  • Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist (HCPCS:36906)
  • Insertion of tunneled central venous tube for infusion (5 years or older) (HCPCS:36558)
  • Insertion of central venous tube with port (5 years or older) (HCPCS:36561)

The enumeration date for this NPI number is 1/31/2017 and was last updated on 3/11/2025.

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
1261QA1903XClinic/CenterAmbulatory SurgicalYes

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: 11/21/2025

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