Organization
STATE OF THE ART SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD ELLENBOGEN M.D. (PRACTICE OWNER)
(310) 276-3183
Entity
Organization
Contact information
Practice address
9201 W SUNSET BLVD, SUITE 202, LOS ANGELES, CA 90069-3701
(310) 276-3183
(310) 276-9154
Mailing address
9201 W SUNSET BLVD, SUITE 202, LOS ANGELES, CA 90069-3701
(310) 276-3183
(310) 276-9154
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1787947
CA
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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