Basic Information
Provider Information
NPI: 1124764592
EntityType: 2
ReplacementNPI:  
OrganizationName: IN-NETWORK SURGERY CENTER, INC.
LastName:  
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Credential:  
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Mailing Information
Address1: 99 N LA CIENEGA BLVD STE 102
Address2:  
City: BEVERLY HILLS
State: CA
PostalCode: 902112286
CountryCode: US
TelephoneNumber: 3103607368
FaxNumber: 8184751813
Practice Location
Address1: 99 N LA CIENEGA BLVD STE 102
Address2:  
City: BEVERLY HILLS
State: CA
PostalCode: 902112286
CountryCode: US
TelephoneNumber: 3103607368
FaxNumber: 8184751813
Other Information
ProviderEnumerationDate: 05/09/2022
LastUpdateDate: 05/09/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SHKLYARENKO
AuthorizedOfficialFirstName: BELLA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 8184308954
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QA1903X  Y Ambulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical

No ID Information.


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