Mid-Wilshire Surgery Center,LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MID-WILSHIRE SURGERY CENTER,LLC

Practice address

5757 Wilshire Blvd # 376
Los Angeles, CA 90036-5810

Phone

(323) 935-9367

Fax

(323) 525-1850

NPI assigned

Mar 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andrew K Choi, M.D.

Title

Administator

Phone

(323) 935-9367

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0001425

Legal name

MID-WILSHIRE SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 15, 1998

Last certification

Jun 22, 2017

Ownership / control type

Proprietary

Facility address

5757 Wilshire Blvd, Suite 374
Los Angeles, CA 90036

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003933011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD # 376",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-935-9367",
            "fax_number": "323-525-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD # 376",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-935-9367",
            "fax_number": "323-525-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-WILSHIRE SURGERY CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "323-935-9367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5224032",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mid City Associated Medical Group, Inc.
• Mid Wilshire Hospice
• Mid Wilshire Pharmacy
• Mid-Valley Imaging, LLC
• Mid-Wilshire Health Care Center
• Erica Miday
• Angela Michelle Middlebrook
• Ebony S Middlebrook, B.A.
• Holly Ruth Middlekauff, MD
• Brittany Middleton, M.D.

• Ambulatory Surgical Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.