Organization
NOVA AMBULATORY SURGERY CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIDA PETTYJOHN (CREDENTIALING ACCT MANAGER)
(512) 454-5911
Entity
Organization
Contact information
Practice address
4542 LAS POSAS RD STE C, CAMARILLO, CA 93010-2532
(805) 585-5004
(805) 484-3099
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
04/19/2023
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