Source Surgery Center Llc

LBN: Source Surgery Center Llc
Source Surgery Center Llc is an health care organization with primary practice located at 2801 Wilshire Blvd , Santa Monica CA 90403-4801. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Source Surgery Center Llc can be contacted via phone (310) 574-2777, or through Davis, Timothy T via phone (310) 574-2777.

Contact Information

Primary practice address
2801 Wilshire Blvd Santa Monica CA 90403-4801
Phone: (310) 574-2777
Fax: (310) 315-4968
Website:
Map and Directions
Authorized official contact:
Name: Davis, Timothy T Doctor of Medicine (MD)
Phone: (310) 574-2777

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X

Profile Details

NPI number 1558802249
LBN Legal business name Source Surgery Center Llc
DBA Doing business as
Authorized official Davis, Timothy T Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2017
Last updated Jan 21st, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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