Elite Surgery Center of South Bay LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ELITE SURGERY CENTER OF SOUTH BAY LLC

Practice address

20528 Hawthorne Blvd Ste 301
Torrance, CA 90503-3202

Phone

(424) 247-9090

NPI assigned

Aug 17, 2020

Last updated

Oct 16, 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. Mehran Taban, MDNPI 1497943914

Title

Chairman, Governing Body

Phone

(424) 247-9090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Elite Surgery Center of South Bay LLCCCN 55C0001103

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Mehran Taban, M.D.

  • Ophthalmology Physician
  • Torrance, CA
  • NPI 1497943914
  NPD Authorized official
• Sepideh H Nolan, RN

  • Registered Nurse
  • Torrance, CA
  • NPI 1851099428
  NPD (past)
• Jordan Alexander Sugarman, MD

  • Ophthalmology Physician
  • Torrance, CA
  • NPI 1326532110
  NPD (past)

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1205448750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20528 HAWTHORNE BLVD STE 301",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905033202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20528 HAWTHORNE BLVD STE 301",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905033202",
            "telephone_number": "424-247-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SURGERY CENTER OF SOUTH BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A",
        "authorized_official_last_name": "TABAN",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "CHAIRMAN, GOVERNING BODY",
        "authorized_official_telephone_number": "424-247-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Talaat Elias, D.O.
• Mary Elias, PHARM.D.
• Michelle Nicole Elias, NONE
• Elisabeth R. Crim, PH.D. Psychological Services, Inc. (Moonstone Center)
• Elite Medical Solutions Inc.
• Elizabeth Jemielita Marriage and Family Therapy Inc
• Kenroy Elizee
• Kay E Elledge, MD
• Ellen J Fraser, M.D. Inc
• Ellen Sora Moon, DMD, Inc. (Moonlight Dentistry)

• Ambulatory Surgical Clinic/Center in Torrance, CA
• Providers in Torrance, 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 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.