Surgical Treatment and Regeneration II, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGICAL TREATMENT AND REGENERATION II, LLC

Doing business as

Star Surgical

Practice address

2711 N Sepulveda Blvd
#223
Manhattan Beach, CA 90266-2725

Phone

(760) 375-3974

Fax

(760) 375-3953

NPI assigned

Apr 6, 2016

Organization subpart

No

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

Authorized official

Name

Neil Ghodadra, MD

Title

Medical Director

Phone

(678) 596-1344

Specialties & licenses 1

Addresses

Other names 1

• Star Surgical Doing business as

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1174987135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S SPALDING DR",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121800",
            "telephone_number": "760-375-3974",
            "fax_number": "760-375-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 N SEPULVEDA BLVD",
            "address_2": "#223",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662725",
            "telephone_number": "760-375-3974",
            "fax_number": "760-375-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL TREATMENT AND REGENERATION II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "GHODADRA",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-596-1344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Star Surgical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Stoker, PHD
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• Robert D Swift, MD
• Sobia Syed, FNP
• Sylvia a Mehl Physical Therapy Inc (Head 2 Toe Physical Therapy)
• Ruth Sze
• Melissa Szymankiewicz, D.C.

• Ambulatory Surgical Clinic/Center in Manhattan Beach, CA
• Providers in Manhattan Beach, 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 Apr 6, 2016; 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.