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Organization
P.S.P. SURGICAL FACILITY
Active
Organization
P.S.P. SURGICAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE R CORWIN M.D. (CHIEF OFFICER)
(805) 494-3656
Entity
Organization
Contact information
Practice address
1250 LA VENTA RD, STE 202, WESTLAKE VILLAGE, CA 91361-3702
(805) 494-3656
Mailing address
1250 LA VENTA RD, STE 202, WESTLAKE VILLAGE, CA 91361-3702
(805) 494-3656
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/26/2007
Last updated
08/22/2020
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