# MODESTO SPECIALTY SURGERY CENTER PC

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

## Provider details

- **NPI number:** 1205177235
- **Authorized official:** DR. DANIEL P. TAHERI MD (PRESIDENT)
- **Authorized official phone:** (310) 993-8994

## Contact information

- **Practice address:** 10884 SANTA MONICA BLVD, \#300, LOS ANGELES, CA 90025-4646
- **Practice address phone:** (310) 993-8994
- **Mailing address:** PO BOX 16297, BEVERLY HILLS, CA 90209-2297
- **Mailing address phone:** (310) 993-8994

## Taxonomy

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

## Other

- **Enumeration date:** 03/15/2013
- **Last updated:** 07/21/2022