Organization
BRENTWOOD AMBULATORY SURGICAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RANDI FETT (ADMINISTRATOR)
(310) 442-9262
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD, 905, LOS ANGELES, CA 90025-1708
(310) 442-9262
Mailing address
11645 WILSHIRE BLVD, LOS ANGELES, CA 90025-1708
(310) 442-9262
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
9300009000
CA
Other
Enumeration date
11/15/2006
Last updated
08/22/2020
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