Organization
SOCAL PRESTIGE SURGICAL INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELINAZ SHOUSHTARI DMD (CHAIRMAN, GOVERNING BODY)
(310) 326-2102
Entity
Organization
Contact information
Practice address
21250 HAWTHORNE BLVD STE 440, TORRANCE, CA 90503-5506
(310) 326-2102
Mailing address
21250 HAWTHORNE BLVD STE 435, TORRANCE, CA 90503-5504
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
05/24/2024
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