Organization
LA TOP SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEVORG MUTAFYAN M.D. (MANAGING MEMBER/OWNER.)
(818) 424-8568
Entity
Organization
Contact information
Practice address
800 S CENTRAL AVE # 100A2, GLENDALE, CA 91204-4370
(818) 424-8568
Mailing address
800 S CENTRAL AVE # 100A2, GLENDALE, CA 91204-4370
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5729
AAAASF
CA
Enumeration date
03/06/2015
Last updated
03/06/2015
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