# ELITE SURGICAL SERVICES

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

## Provider details

- **NPI number:** 1487042859
- **Authorized official:** NOSRAT KHAJAVI M.D. (PRESIDENT/ SOLE OWNER)
- **Authorized official phone:** (510) 556-1000

## Contact information

- **Practice address:** 1860 MOWRY AVE, STE.\#401, FREMONT, CA 94538-1730
- **Practice address phone:** (510) 556-1000
- **Practice address fax:** (510) 878-4444
- **Mailing address:** 19197 GOLDEN VALLEY RD, ST.\#444, CANYON COUNTRY, CA 91387-1428
- **Mailing address phone:** (510) 556-1000

## Taxonomy

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

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 05/22/2015