# GRAND AVENUE SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1558832741
- **Authorized official:** DR. GREG HORNER MD (CEO)
- **Authorized official phone:** (925) 984-4734

## Contact information

- **Practice address:** 1400 S GRAND AVE STE 700, LOS ANGELES, CA 90015-3068
- **Practice address phone:** (213) 866-1900
- **Practice address fax:** (213) 275-1393
- **Mailing address:** 1400 S GRAND AVE STE 700, LOS ANGELES, CA 90015-3068
- **Mailing address phone:** (213) 866-1900
- **Mailing address fax:** (213) 275-1393

## Taxonomy

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

## Other

- **Enumeration date:** 12/16/2018
- **Last updated:** 12/04/2020