Basic Information
| Provider Information | |||||||||
| NPI: | 1982821708 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WARDLOW SURGERY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 HAMPSHIRE RD | ||||||||
| Address2: | 200 | ||||||||
| City: | WESTLAKE VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913612504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054973736 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 W WARDLOW RD | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908074429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624243574 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2007 | ||||||||
| LastUpdateDate: | 03/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | BUCKLEY | ||||||||
| AuthorizedOfficialFirstName: | ANDREE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8054973736 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.