# NOVA AMBULATORY SURGERY CENTER LP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1316579055
- **Authorized official:** ELIDA PETTYJOHN (CREDENTIALING ACCT MANAGER)
- **Authorized official phone:** (512) 454-5911

## Contact information

- **Practice address:** 4542 LAS POSAS RD STE C, CAMARILLO, CA 93010-2532
- **Practice address phone:** (805) 585-5004
- **Practice address fax:** (805) 484-3099
- **Mailing address:** PO BOX 3129, TORRANCE, CA 90510-3129
- **Mailing address phone:** (310) 792-3914
- **Mailing address fax:** (855) 898-4055

## Taxonomy

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

## Other

- **Enumeration date:** 02/11/2020
- **Last updated:** 04/19/2023