# INTEGRATIVE OPERATING THEATRES, INC.

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

## Provider details

- **NPI number:** 1780277012
- **Authorized official:** DR. GLENN VALLECILLOS MD (CEO/MEDICAL DIRECTOR)
- **Authorized official phone:** (310) 273-3007

## Contact information

- **Practice address:** 9675 BRIGHTON WAY STE B1, BEVERLY HILLS, CA 90210-5144
- **Practice address phone:** (310) 273-3007
- **Practice address fax:** (310) 733-1818
- **Mailing address:** 9675 BRIGHTON WAY STE 380, BEVERLY HILLS, CA 90210-5187
- **Mailing address phone:** (310) 273-3007
- **Mailing address fax:** (310) 733-1818

## Taxonomy

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

## Other

- **Enumeration date:** 02/17/2021
- **Last updated:** 01/17/2022