# KINTSUGI SURGICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ROBOTICS OUTPATIENT CENTER LOS ANGELES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912506601
- **Authorized official:** DEREK TAN DEE MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (213) 328-3600

## Contact information

- **Practice address:** 1127 WILSHIRE BLVD STE 1000, LOS ANGELES, CA 90017-4001
- **Practice address phone:** (213) 328-3600
- **Practice address fax:** (213) 395-0683
- **Mailing address:** 1127 WILSHIRE BLVD STE 1000, LOS ANGELES, CA 90017-4001
- **Mailing address phone:** (213) 328-3600
- **Mailing address fax:** (213) 395-0683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/22/2020
- **Last updated:** 07/27/2021