Provider Demographics
NPI:1053556670
Name:SANTA MONICA OUTPATIENT SURGERY CENTER
Entity type:Organization
Organization Name:SANTA MONICA OUTPATIENT SURGERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-592-0266
Mailing Address - Street 1:2001 SANTA MONICA BLVD., SUITE 1180W
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-829-5550
Mailing Address - Fax:310-829-5502
Practice Address - Street 1:2001 SANTA MONICA BLVD., SUITE 1180W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-829-5550
Practice Address - Fax:310-829-5502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLASTIKKIRURGI, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-10
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical