institution
Premier Surgical Pavilion Of La
Ambulatory Surgical Clinic/Center in Los Angeles, California
NPI 1114589793

Premier Surgical Pavilion Of La is an Ambulatory Surgical Clinic/Center based in New York, CA and is specialized in Ambulatory Surgical. Premier Surgical Pavilion Of La practices in Los Angeles, CA. The NPI Number for Premier Surgical Pavilion Of La is 1114589793 and holds a License No. (California).

The current practice location address for Premier Surgical Pavilion Of La is 11661 San Vicente Blvd, Los Angeles, CA and can be reached out via phone at 212-223-0716.

Location: 11661 San Vicente Blvd, Los Angeles, CA, 10016-0943
institution
Provider Profile Details
NPI Number
1114589793
Provider Name
Premier Surgical Pavilion Of La
Credential
Provider Entity Type
Organization
Address
11661 San Vicente Blvd, Los Angeles, CA, 10016-0943
Phone Number
212-223-0716
Fax Number
Provider Enumeration Date
07/03/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C53266 01 CA MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
11661 San Vicente Blvd
City
State
Zip
90049-5103
Phone Number
212-223-0716
Fax Number
person
Provider Business Mailing Address Details
Address
11661 San Vicente Blvd
City
State
Zip
90049-5103
Phone Number
212-223-0716
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
License No.
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Definition
Definition to come...
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