Encino Place Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

G53604 Issued in CA

Legal business name

ENCINO PLACE SURGERY CENTER

Practice address

16101 Ventura Blvd Ste 240
Encino, CA 91436-2513

Phone

(818) 784-9304

Fax

(818) 784-9307

NPI assigned

Mar 27, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David George Glick, M.DNPI 1235257049

Title

President

Phone

(818) 784-9304

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Georg Glick, M.D.

  • Plastic Surgery Physician
  • Encino, CA
  • NPI 1235257049
  NPD (past) Authorized official

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083732721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5091 WESTWOOD ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630231",
            "telephone_number": "818-784-9304",
            "fax_number": "818-784-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD STE 240",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362513",
            "telephone_number": "818-784-9304",
            "fax_number": "818-784-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCINO PLACE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-784-9304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G53604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Encino Orthodontics
• Encino Outpatient Surgery Center, LLC
• Encino Place Pain & Surgery Center LLC
• Encino Place Pain Management and Surgery Center Inc
• Encino Place Pain Management and Surgery Center, Inc.
• Encino Plaza Surgical Center (Urological Institute of Southern California)
• Encino Procare Medical Center PC
• Encino Recovery Center, Inc.
• Encino Recovery, Inc. (Amber Recovery)
• Encino Spine & Pain Surgery Center

• Ambulatory Surgical Clinic/Center in Encino, CA
• Providers in Encino, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.