Provider Demographics
NPI:1578303582
Name:LOS ANGELES SURGERY CENTER INC
Entity type:Organization
Organization Name:LOS ANGELES SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROUNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-988-9090
Mailing Address - Street 1:PO BOX 19211
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-9211
Mailing Address - Country:US
Mailing Address - Phone:818-988-9090
Mailing Address - Fax:
Practice Address - Street 1:16119 VANOWEN ST STE B
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-4822
Practice Address - Country:US
Practice Address - Phone:818-988-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical