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Organization

PREMIER PACIFIC SURGICAL INSTITUTE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT FULLER (GENERAL COUNSEL)
(310) 203-2803
Entity
Organization

Contact information

Practice address
1406 CRENSHAW BLVD, TORRANCE, CA 90501-2433
(310) 905-8884
Mailing address
21213-B HAWTHORNE BLVD., SUITE 101, TORRANCE, CA 90503-5595
(310) 905-8884

Taxonomy

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

Other

Enumeration date
06/22/2017
Last updated
07/21/2022
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