Organization
THIRD STREET SURGERY CENTER LLC
Active
Other names
Third Street Surgery Center LP
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX LIU MD (VICE PRESIDENT/MEDICAL DIRECTOR)
(213) 617-9194
Entity
Organization
Contact information
Practice address
420 E 3RD ST STE 110, LOS ANGELES, CA 90013-1645
(213) 617-9194
Mailing address
420 E 3RD ST, SUITE 110, LOS ANGELES, CA 90013-1644
(213) 617-9194
(213) 617-0605
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
930001001
CA
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR01330G
—
CA
Enumeration date
01/10/2007
Last updated
11/04/2021
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