SURGICAL SUITE OF SOUTHERN CALIFORNIA, A MEDICAL CORPORATION (NPI# 1124187208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124187208 |
| Entity Type | Organization |
| Organization Name | SURGICAL SUITE OF SOUTHERN CALIFORNIA, A MEDICAL CORPORATION |
| Practice Address |
1040 Elm Ave Ste 100 Long Beach CA 90813-3265 |
| Mailing Address |
Po Box 2677 Los Alamitos CA 90720-7677 |
| Practice Telephone | 5625914444 |
| Practice Fax Number | 5624367350 |
| Mailing Telephone | 7149350073 |
| Mailing Fax Number | 7149350075 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2009-07-14 |
| Authorized Official Name | MS. BARBARA JO CLEM (BILLING AND CONTRACTING) |
| Authorized Official Telephone | 7149350073 |
| Authorized Official Credential | RN, CPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
AAAHC21768 | CA | Ambulatory Health Care Facilities |
| Street Address |
1040 ELM AVE STE 100 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90813-3265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821537275 | California Surgical Suites, LLC | Clinic/Center | 1040 Elm Ave Ste 100, Long Beach, CA 90813-3265 | 2017-02-17 |
| 1245673896 | Nolan Stephen Desa | Surgery | 1040 Elm Ave Ste 100, Long Beach, CA 90813-3265 | 2013-04-14 |
| 1740464551 | Eric Voldeng | Physician Assistant | 1040 Elm Ave Ste 100, Long Beach, CA 90813-3265 | 2007-12-28 |
| 1235269093 | Faustino Bernadett M.d. | Clinic/Center | 1040 Elm Ave Ste 100, Long Beach, CA 90813-3265 | 2007-03-07 |
| 1033249271 | Faustino Bernadett M.d. | Clinic/Center | 1040 Elm Ave Ste 100, Long Beach, CA 90813-3265 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018491 | Marisol Zobler | Social Worker | 820 Long Beach Bvld, Long Beach, CA 90813 | 2020-06-19 |
| 1437787009 | Cho Rok Kim | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave., Long Beach, CA 90813 | 2020-03-30 |
| 1316407596 | Vicky Sandhu | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave, Long Beach, CA 90813 | 2019-03-22 |
| 1245734912 | Madiha Naseem | Internal Medicine | Graduate Medical Education, 1050 Linden Avenue, Long Beach, CA 90813 | 2018-03-19 |
| 1689194508 | Naomi Ruiz | Specialist/Technologist | 838 Pine Ave Apt. 314, Long Beach, CA 90813 | 2017-06-21 |
| 1851831531 | Tyler Lappen | Student in an Organized Health Care Education/Training Program | 830 Atlantic Ave., Long Beach, CA 90813 | 2017-03-01 |
| 1639628886 | Assavuth Kim | Community Health Worker | 1471 Cherry Avenue, Long Beach, CA 90813 | 2016-09-29 |
| 1881031300 | Stacy Nicole Delgado-willis | Marriage & Family Therapist | 851 Pine Ave Ste 103, Long Beach, CA 90813 | 2013-05-23 |
| 1740623453 | Paula Ann Di Thomas | Nurse Practitioner | 1043 Elm Ave #104, Long Beach, CA 90813 | 2013-04-11 |
| 1629322722 | David O Chavez | Case Manager/Care Coordinator | 820 Long Beach Blvd, Long Beach, CA 90813 | 2012-10-29 |
| Find all providers in zip 90813 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598393076 | Estea Ambulatory Surgery Center, LLC | Clinic/Center | 3440 Atlantic Ave Ste 3, Long Beach, CA 90807-4568 | 2020-03-30 |
| 1750768537 | Wrigley Medical Surgicenter, LLC | Clinic/Center | 2240 Pacific Ave, Long Beach, CA 90806-4372 | 2015-04-30 |
| 1902211477 | Westview Medical Surgical Center, LLC | Clinic/Center | 2990 E Pacific Coast Hwy Ste B, Long Beach, CA 90804-1632 | 2014-06-24 |
| 1881834596 | Long Beach Out Pt Surgery Center | Clinic/Center | 2370 Long Beach Blvd, Long Beach, CA 90806-3260 | 2009-02-20 |
| 1851508667 | South Bay Surgical and Spine Institute | Clinic/Center | 4300 Long Beach Blvd Ste 150, Long Beach, CA 90807-2016 | 2007-05-17 |
| 1982821708 | Wardlow Surgery Center | Clinic/Center | 200 W Wardlow Rd, Long Beach, CA 90807-4429 | 2007-04-20 |
| 1154310753 | Long Beach Pain Center & Medical Clinic | Clinic/Center | 2760 Pacific Ave, Long Beach, CA 90806-2613 | 2005-10-17 |
| 1043217615 | Long Beach Surgery Center, Lp | Clinic/Center | 2880 Atlantic Avenue, Suite 160, Long Beach, CA 90806-1715 | 2005-06-28 |
| 1033686951 | Xcell Surgery Center LLC | Clinic/Center | 200 W Wardlow Rd, Long Beach, CA 90807-4429 | 2018-10-29 |
| 1164909578 | Center for Specialty Surgery LLC | Clinic/Center | 4401 Atlantic Ave Ste 101, Long Beach, CA 90807-2260 | 2018-07-27 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90813 |
Please comment or provide details below to improve the information on SURGICAL SUITE OF SOUTHERN CALIFORNIA, A MEDICAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.