Organization
IMED SURGICAL OF LA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER R MYERS (CLINICAL COMPLIANCE MANAGER)
(631) 479-3496
Entity
Organization
Contact information
Practice address
8540 S SEPULVEDA BLVD STE 900, LOS ANGELES, CA 90045-3808
(323) 287-9273
Mailing address
PO BOX 1970, NEW YORK, NY 10156-1970
(323) 287-9273
(917) 791-9672
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/15/2019
Last updated
09/18/2025
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