# SANJIV KUMAR JAIN, MD., A CALIFORNIA MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SANJIV KUMAR JAIN, MD., A CALIFORNIA MEDICAL CORPORATION
- **Other names:** LA AMBULATORY SURGERY CENTER, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1952822959
- **Legal business name:** SANJIV KUMAR JAIN, MD., A CALIFORNIA MEDICAL CORPORATION
- **Authorized official:** DR. SANJIV KUMAR JAIN MD (PRESIDENT)
- **Authorized official phone:** (818) 366-0474

## Contact information

- **Practice address:** 11177 TAMPA AVE STE B, NORTHRIDGE, CA 91326-2254
- **Practice address phone:** (818) 366-0474
- **Practice address fax:** (818) 360-6319
- **Mailing address:** PO BOX 8000, NORTHRIDGE, CA 91327-8000
- **Mailing address phone:** (818) 366-0474
- **Mailing address fax:** (818) 360-6319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | A47841 | CA | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A47841 | CA | Yes |

## Other

- **Enumeration date:** 06/29/2017
- **Last updated:** 06/29/2017