Organization
COAST SURGERY CENTER L P
Active
Other names
Coast Surgery Center of South Bay
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER, AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
3445 PACIFIC COAST HWY, STE 110, TORRANCE, CA 90505-6658
(310) 325-4555
(310) 325-5005
Mailing address
3445 PACIFIC COAST HWY, STE 110, TORRANCE, CA 90505-6658
(310) 325-4555
(310) 325-5005
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
CLN794
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00080885
RAILROAD MEDICARE
CA
Enumeration date
07/15/2005
Last updated
09/18/2024
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