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Organization
STATE OF THE ART SURGERY CENTER
Active
Organization
STATE OF THE ART SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD ELLENBOGEN M.D. (PRACTICE OWNER)
(310) 276-3183
Entity
Organization
Contact information
Practice address
9201 W SUNSET BLVD, SUITE 202, LOS ANGELES, CA 90069-3701
(310) 276-3183
(310) 276-9154
Mailing address
9201 W SUNSET BLVD, SUITE 202, LOS ANGELES, CA 90069-3701
(310) 276-3183
(310) 276-9154
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1787947
CA
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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