DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP NPI 1679694392

NPI Information

  • NPI: 1679694392
  • Provider Name: DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Former Legal Business Name: DIRECTED INTERVENTIONAL SURGERY CENTER
  • CLIA Number: 05D2107462
  • Address: 2827 WILSHIRE BLVD
    SANTA MONICA, CA
    ZIP 90403
  • Phone: (310) 829-9788

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NPI Details

DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP is an ambulatory surgical clinic center in Santa Monica, CA. DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP NPI is 1679694392. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Directed Interventional Surgery Center.

The provider's business location address is:

2827 WILSHIRE BLVD
SANTA MONICA, CA
ZIP 90403-801
Phone: (310) 829-9788
Fax: (310) 453-1576

The provider's authorized official is Sally Case .
The authorized official title is Billing Manager and has the following contact phone number (310) 829-9788.

The CLIA number assigned to this NPI record is 05D2107462 - 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.

  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)

The enumeration date for this NPI number is 4/2/2007 and was last updated on 2/3/2017.

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 SurgicalS051520CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S051520MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2GR0070730MEDICAIDCALIFORNIA

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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