Radiance Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0003011010-0001-0 Issued in CA

Legal business name

RADIANCE SURGERY CENTER LLC

Practice address

5170 Sepulveda Blvd Ste 240
Sherman Oaks, CA 91403-1190

Phone

(818) 783-5000

Fax

(818) 783-5001

NPI assigned

Oct 31, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Aziz Berjis, DPM

Title

President

Phone

(818) 783-5000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1063924017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 SEPULVEDA BLVD STE 240",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031190",
            "telephone_number": "818-783-5000",
            "fax_number": "818-783-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 SEPULVEDA BLVD STE 240",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031190",
            "telephone_number": "818-783-5000",
            "fax_number": "818-783-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "BERJIS",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-783-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "0003011010-0001-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Sherman Oaks, CA
• Providers in Sherman Oaks, 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 Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.