Organization
PACIFIC COAST SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RIFAAT DOVER SALEM M.D (MEDICAL DIRECTOR)
(310) 376-7000
Entity
Organization
Contact information
Practice address
3720 LOMITA BLVD, 100, TORRANCE, CA 90505-3884
(310) 376-7000
(310) 373-0319
Mailing address
3720 LOMITA BLVD, 100, TORRANCE, CA 90505-3884
(310) 376-7000
(310) 373-0319
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G46242
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G46242
LICENSE
CA
Enumeration date
05/16/2007
Last updated
08/22/2020
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