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Organization
INTEGRATIVE OPERATING THEATRES, INC.
Active
Organization
INTEGRATIVE OPERATING THEATRES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN VALLECILLOS MD (CEO/MEDICAL DIRECTOR)
(310) 273-3007
Entity
Organization
Contact information
Practice address
9675 BRIGHTON WAY STE B1, BEVERLY HILLS, CA 90210-5144
(310) 273-3007
(310) 733-1818
Mailing address
9675 BRIGHTON WAY STE 380, BEVERLY HILLS, CA 90210-5187
(310) 273-3007
(310) 733-1818
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/17/2021
Last updated
01/17/2022
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