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1558802249
SOURCE SURGERY CENTER LLC
SANTA MONICA, CA
NPI
1558802249
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Entity Type
Organization
Authorized Contact
TIMOTHY T DAVIS
Owner
310-574-2777
Organization Subpart ?
No
Primary Taxonomy
261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date
2017-03-14
Last Update Date
2020-01-21
Business Address
SOURCE SURGERY CENTER LLC
2801 WILSHIRE BLVD
SANTA MONICA, CA 90403-4801
Phone number: 310-574-2777
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Mailing Address
SOURCE SURGERY CENTER LLC
1112 MONTANA AVE SUITE 900
SANTA MONICA, CA 90403-1652
Phone number: 310-574-2777
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