Organization
AESTHETIC SURGICAL CENTER OF SANTA MONICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN ALAN TEITELBAUM M.D. (CHIEF EXECUTIVE OFFICER)
(310) 315-1121
Entity
Organization
Contact information
Practice address
1301 20TH ST STE 350, SANTA MONICA, CA 90404-2052
(310) 315-1121
(310) 315-9921
Mailing address
1301 20TH ST STE 350, SANTA MONICA, CA 90404-2052
(310) 315-1121
(310) 315-9921
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
105461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740335744
—
CA
Enumeration date
01/23/2007
Last updated
06/12/2017
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