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Organization

LAKESIDE SURGERY CENTER LP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA R DEBRUNO (ADMINISTRATOR)
(818) 637-7766
Entity
Organization

Contact information

Practice address
5700 SAN FERNANDO RD, GLENDALE, CA 91202-2104
(818) 637-7766
(818) 956-1706
Mailing address
5700 SAN FERNANDO RD, GLENDALE, CA 91202-2104
(818) 637-7766
(818) 956-1706

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
06/08/2006
Last updated
12/13/2007
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