# BROADWAY SURGICAL INSTITUTE, LLC

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

## Provider details

- **NPI number:** 1578605044
- **Authorized official:** DR. ALEXANDER P HERSEL M.D. (DIRECTOR)
- **Authorized official phone:** (310) 260-2827

## Contact information

- **Practice address:** 1451 S BROADWAY STREET, SANTA MONICA, CA 90404-1811
- **Practice address phone:** (310) 260-2827
- **Mailing address:** 1451 BROADWAY, SANTA MONICA, CA 90404-2711
- **Mailing address phone:** (602) 298-2653
- **Mailing address fax:** (602) 298-2686

## Taxonomy

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

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 01/10/2013