Organization
BUENA VISTA SURGERY CENTER MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE W ODELL (MANAGING MEMBER)
(805) 679-7560
Entity
Organization
Contact information
Practice address
2701 W. ALAMEDA AVENUE, SUITE 401B, BURBANK, CA 91505-4409
(805) 823-6688
(805) 617-1743
Mailing address
121 GRAY AVENUE, SUITE 200, SANTA BARBARA, CA 93101-1800
(888) 282-7472
(805) 563-5410
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Enumeration date
10/29/2007
Last updated
09/22/2014
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