Provider Demographics
NPI:1447476668
Name:SBA OUTPATIENT SURGERY CENTER, INC
Entity type:Organization
Organization Name:SBA OUTPATIENT SURGERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VERBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-539-6500
Mailing Address - Street 1:371 VAN NESS WAY, SUITE 210
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-6297
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-874-5394
Practice Address - Street 1:3600 LOMITA BOULEVARD
Practice Address - Street 2:SUITE 101
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3900
Practice Address - Country:US
Practice Address - Phone:310-539-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical