PACIFIC PALISADES SURGERY CENTER AND MEDICAL GROUP INC NPI 1689795312

NPI Information

PACIFIC PALISADES SURGERY CENTER AND MEDICAL GROUP INC is an ambulatory surgical clinic center in Santa Monica, CA. PACIFIC PALISADES SURGERY CENTER AND MEDICAL GROUP INC NPI is 1689795312. The provider is registered as an organization entity type.
The provider Is Doing Business As Pacific Surgery Center Of Santa Monica.

The provider's business location address is:

2021 SANTA MONICA BLVD
SUITE 724E
SANTA MONICA, CA
ZIP 90404-208
Phone: (310) 829-9060
Fax: (310) 829-9015

The provider's authorized official is Cynthia A. Boxrud .
The authorized official title is Director and has the following contact phone number (310) 829-9060.

The CLIA number assigned to this NPI record is 05D2101523 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 2/2/2010.

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

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

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