| Encino Outpatient Surgery Center, Llc | |
|
16311 Ventura Boulevard Suite 580 Encino CA 91436-4314 | |
| (818) 986-1037 | |
| (818) 986-1800 |
| Full Name | Encino Outpatient Surgery Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16311 Ventura Boulevard, Encino, California |
| Authorized Official Name and Position | Suhel Siddiqui (CEO) |
| Authorized Official Contact | 8189861037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Encino Outpatient Surgery Center, Llc 16311 Ventura Boulevard Suite 580 Encino CA 91436-4314 Ph: (818) 986-1037 | Encino Outpatient Surgery Center, Llc 16311 Ventura Boulevard Suite 580 Encino CA 91436-4314 Ph: (818) 986-1037 |
| NPI Number | 1629132360 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 12/04/2019 |
| Medicare PECOS PAC ID | 6103089982 |
|---|---|
| Medicare Enrollment ID | O20120514000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629132360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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