Organization
IE SURGICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN F OSBORNE M.D. (OWNER)
(310) 657-0871
Entity
Organization
Contact information
Practice address
8631 W 3RD ST STE 945E, LOS ANGELES, CA 90048-5912
(310) 657-0871
(310) 657-0142
Mailing address
PO BOX 451400, WESTCHESTER, CA 90045-8515
(310) 657-0871
(310) 657-0142
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
002172882-0001-6
CA
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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