Organization
MODESTO SPECIALTY SURGERY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL P. TAHERI MD (PRESIDENT)
(310) 993-8994
Entity
Organization
Contact information
Practice address
10884 SANTA MONICA BLVD, #300, LOS ANGELES, CA 90025-4646
(310) 993-8994
Mailing address
PO BOX 16297, BEVERLY HILLS, CA 90209-2297
(310) 993-8994
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
CA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2013
Last updated
07/21/2022
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