Basic Information
| Provider Information | |||||||||
| NPI: | 1205076593 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTHCARE PARTNERS ASC-HB, LLC | ||||||||
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| OtherOrganizationName: | TALBERT SURGICAL ASSOCIATES, LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 6400 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905046400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105253868 | ||||||||
| FaxNumber: | 3107835581 | ||||||||
| Practice Location | |||||||||
| Address1: | 7677 CENTER STREET | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926473030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148818700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2009 | ||||||||
| LastUpdateDate: | 08/20/2019 | ||||||||
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| AuthorizedOfficialLastName: | LIETHEN | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | G. | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 9522056262 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | A272769 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
ID Information
| ID | Type | State | Issuer | Description | A272769 | 01 | CA | BUSINEE LICENSE # | OTHER |