Organization
NOVAMED SURGERY CENTER OF WHITTIER LLC
Active
Other names
Center for Outpatient Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
15141 WHITTIER BLVD, SUITE 130, WHITTIER, CA 90603-2145
(562) 945-2832
(562) 945-2174
Mailing address
15141 WHITTIER BLVD, SUITE 130, WHITTIER, CA 90603-2135
(562) 945-2832
(562) 945-2174
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
930000917
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051412
BC OF CA
CA
01
—
P00285847
RR MEDICARE
—
05
—
SUR01412G
—
CA
01
—
ZZZH1940B
BS OF CA
CA
Enumeration date
05/19/2006
Last updated
02/15/2023
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