# STATE OF THE ART SURGERY CENTER

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

## Provider details

- **NPI number:** 1710152590
- **Authorized official:** MR. RICHARD ELLENBOGEN M.D. (PRACTICE OWNER)
- **Authorized official phone:** (310) 276-3183

## Contact information

- **Practice address:** 9201 W SUNSET BLVD, SUITE 202, LOS ANGELES, CA 90069-3701
- **Practice address phone:** (310) 276-3183
- **Practice address fax:** (310) 276-9154
- **Mailing address:** 9201 W SUNSET BLVD, SUITE 202, LOS ANGELES, CA 90069-3701
- **Mailing address phone:** (310) 276-3183
- **Mailing address fax:** (310) 276-9154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1787947 | CA | Yes |

## Other

- **Enumeration date:** 04/23/2008
- **Last updated:** 04/23/2008