Organization · Type 2 NPI

Source Surgery Center LLC

Ambulatory Surgical Clinic/Center · Santa Monica, CA

NPI number 1558802249 Active

Practice location

2801 Wilshire Blvd
Santa Monica, CA 90403-4801

Call (310) 574-2777 Map

Fax (310) 315-4968

Mailing address

1112 Montana Ave, Suite 900
Santa Monica, CA 90403-1652

Specialties and licenses

TaxonomyCodeLicense
Ambulatory Surgical Clinic/Center Primary 261QA1903XNone listed

Ambulatory Surgical Clinic/Center: Definition to come...

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About NPI 1558802249

Source Surgery Center LLC's National Provider Identifier is 1558802249, issued on Mar 14, 2017. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Santa Monica, CA. The record was last updated on Jan 21, 2020.