Organization
DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP
Active
Other names
Directed Interventional Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY CASE (BILLING MANAGER)
(310) 829-9788
Entity
Organization
Contact information
Practice address
2827 WILSHIRE BLVD, SANTA MONICA, CA 90403-4801
(310) 829-9788
(310) 453-1576
Mailing address
2827 WILSHIRE BLVD, SANTA MONICA, CA 90403
(310) 829-9788
(310) 453-1576
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
S051520
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0070730
—
CA
Enumeration date
04/02/2007
Last updated
02/03/2017
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