# LAKEWOOD FUNCTIONAL RESTORATION ASC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194264556
- **Authorized official:** ELENA SERDA (DIRECTOR)
- **Authorized official phone:** (661) 472-4177

## Contact information

- **Practice address:** 5750 DOWNEY AVE STE 302, LAKEWOOD, CA 90712-1476
- **Practice address phone:** (661) 472-4177
- **Mailing address:** 5750 DOWNEY AVE STE 302, LAKEWOOD, CA 90712-1476
- **Mailing address phone:** (661) 472-4177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/17/2017
- **Last updated:** 02/17/2017