Organization
CONEJO VALLEY OUTPATIENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FAN MD (MEDICAL DIRECTOR)
(310) 846-4155
Entity
Organization
Contact information
Practice address
1127 WILSHIRE BLVD, SUITE 1000, LOS ANGELES, CA 90017-3901
(310) 846-4155
Mailing address
PO BOX 881840, LOS ANGELES, CA 90009-3013
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2014
Last updated
11/02/2015
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