# SOCAL PRESTIGE SURGICAL INSTITUTE

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

## Provider details

- **NPI number:** 1255956538
- **Authorized official:** DR. ELINAZ SHOUSHTARI DMD (CHAIRMAN, GOVERNING BODY)
- **Authorized official phone:** (310) 326-2102

## Contact information

- **Practice address:** 21250 HAWTHORNE BLVD STE 440, TORRANCE, CA 90503-5506
- **Practice address phone:** (310) 326-2102
- **Mailing address:** 21250 HAWTHORNE BLVD STE 435, TORRANCE, CA 90503-5504

## Taxonomy

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

## Other

- **Enumeration date:** 06/11/2020
- **Last updated:** 05/24/2024