# SOUTH PACIFIC MEDICAL ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Pacific Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265629810
- **Authorized official:** KRISTINA KUTSINA (MANAGER)
- **Authorized official phone:** (818) 990-9080

## Contact information

- **Practice address:** 16311 VENTURA BLVD, STE\#1010, ENCINO, CA 91436-2124
- **Practice address phone:** (818) 990-9080
- **Practice address fax:** (818) 990-9758
- **Mailing address:** 16311 VENTURA BLVD, STE\#1010, ENCINO, CA 91436-2124
- **Mailing address phone:** (818) 990-9080
- **Mailing address fax:** (818) 990-9758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 90472196 | CA | Yes |

## Other

- **Enumeration date:** 09/27/2007
- **Last updated:** 10/12/2007