SAN VICENTE SURGERY CENTER, LLC (NPI# 1932275054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932275054 |
| Entity Type | Organization |
| Organization Name | SAN VICENTE SURGERY CENTER, LLC |
| Practice Address |
11645 Wilshire Blvd Ste 987 Los Angeles CA 90025-6814 |
| Practice Telephone | 3102898600 |
| Mailing Telephone | 3102898600 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | DR. STEVEN N BROURMAN (GOVERNING BODY) |
| Authorized Official Telephone | 3102898600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
261QA1903X | CA | Ambulatory Health Care Facilities |
| Street Address |
11645 WILSHIRE BLVD STE 987 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90025-6814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518502699 | Cs Surgery Center | Clinic/Center | 11645 Wilshire Blvd Ste 987, Los Angeles, CA 90025-6814 | 2019-11-12 |
| 1619478567 | Tyler J Roubidoux Md PC | Anesthesiology | 11645 Wilshire Blvd Ste 987, Los Angeles, CA 90025-6814 | 2018-02-26 |
| 1619414018 | Diesel Surgery Center | Obstetrics & Gynecology | 11645 Wilshire Blvd Ste 987, Los Angeles, CA 90025-6814 | 2017-01-23 |
| 1699218313 | West Surgery Center | Clinic/Center | 11645 Wilshire Blvd Ste 987, Los Angeles, CA 90025-6814 | 2016-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1245852599 | Maureen Bridget Mcglynn | Marriage & Family Therapist | 1531 Purdue Avenue, Los Angeles, CA 90025 | 2020-05-09 |
| 1578118857 | Gregory J Bogie | Physical Therapist | 10351 Santa Monica Blvd. Suite 101, Los Angeles, CA 90025 | 2019-08-05 |
| 1518527712 | David Allen Goldstein | Marriage & Family Therapist | 12301 Wilshire Blvd., Suite 515, Los Angeles, CA 90025 | 2019-06-19 |
| 1386104875 | Kevin Meir Youssefzadeh | Student in an Organized Health Care Education/Training Program | 304 Dowlen Dr, Los Angeles, CA 90025 | 2019-03-21 |
| 1336609189 | Psychotherapy Center for Healing and Personal Growth | Psychologist | 2001 S. Barington Ave Suite 222, Los Angeles, CA 90025 | 2019-03-20 |
| 1477028819 | Flora Ma | Nurse Practitioner | 1726 Purdue Ave, Apt 2, Los Angeles, CA 90025 | 2018-10-12 |
| 1457834285 | Yeesul Yoo | Chiropractor | 2001 S. Barrington Ave Suite 101, Los Angeles, CA 90025 | 2018-09-07 |
| 1902387160 | Angelica Carmen Regalado | Behavior Technician | 7400 Pacific Blvd. Suite A & B, Walnut Park, CA 90025 | 2018-08-26 |
| 1033603378 | Craig Allen Gillett | Marriage & Family Therapist | 11847 Wilshire Blvd., #300, Los Angeles, CA 90025 | 2018-06-20 |
| Find all providers in zip 90025 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1912542994 | Reproductive Medicine Associates of Socal Ambulatory Surgery Center | Clinic/Center | 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 | 2019-11-13 |
| 1659926327 | Westside Anesthesia Group A Medical Corporation | Clinic/Center | 1964 Westwood Blvd Ste 436, Los Angeles, CA 90025-4695 | 2019-08-08 |
| 1558832741 | Grand Avenue Surgery Center, LLC | Clinic/Center | 1513 S Grand Ave Ste 350, Los Angeles, CA 90015-3075 | 2018-12-16 |
| 1700351194 | Integrative Surgical Associates Group, LLC. | Clinic/Center | 5757 Wilshire Blvd # P2, Los Angeles, CA 90036-5810 | 2018-10-11 |
| 1982180782 | Robertson Surgery Center Inc. | Clinic/Center | 822 S Robertson Blvd Ste 100b, Los Angeles, CA 90035-1613 | 2018-07-14 |
| 1972055382 | Alliance Surgery Partners, LLC | Clinic/Center | 1828 E Cesar Chavez Ave, Los Angeles, CA 90033-2424 | 2016-11-02 |
| 1164895744 | Los Angeles Ambulatory Surgery Center LLC | Clinic/Center | 266 S Harvard Blvd Ste 200, Los Angeles, CA 90004-4339 | 2015-11-04 |
| 1255752747 | Elite Surgery Center of Beverly Hills | Clinic/Center | 6310 San Vicente Blvd Ste 101b, Los Angeles, CA 90048-5498 | 2013-12-30 |
| 1942548003 | Sierra Surgical Services, LLC | Clinic/Center | 2202 S Figueroa St # 6601, Los Angeles, CA 90007-2049 | 2013-01-24 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90025 |
Please comment or provide details below to improve the information on SAN VICENTE SURGERY CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.