Basic Information
| Provider Information | |||||||||
| NPI: | 1528533254 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DOCS SURGICAL HOSPITAL, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8436 W 3RD ST STE 900 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900484163 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6000 SAN VICENTE BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900364404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3239301040 | ||||||||
| FaxNumber: | 3239349137 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2018 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| AuthorizedOfficialLastName: | SIDDIQUE | ||||||||
| AuthorizedOfficialFirstName: | KHAWAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3107465918 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.