# BUENA VISTA SURGERY CENTER MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1407035215
- **Authorized official:** DAVE W ODELL (MANAGING MEMBER)
- **Authorized official phone:** (805) 679-7560

## Contact information

- **Practice address:** 2701 W. ALAMEDA AVENUE, SUITE 401B, BURBANK, CA 91505-4409
- **Practice address phone:** (805) 823-6688
- **Practice address fax:** (805) 617-1743
- **Mailing address:** 121 GRAY AVENUE, SUITE 200, SANTA BARBARA, CA 93101-1800
- **Mailing address phone:** (888) 282-7472
- **Mailing address fax:** (805) 563-5410

## Taxonomy

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

## Other

- **Enumeration date:** 10/29/2007
- **Last updated:** 09/22/2014