Elite Outpatient Surgical Institute, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ELITE OUTPATIENT SURGICAL INSTITUTE, INC

Practice address

18909 Sherman Way
Suite C
Reseda, CA 91335-6184

Phone

(818) 774-1309

Fax

(818) 774-9719

NPI assigned

Jun 20, 2022

Organization subpart

No

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

Authorized official

Name

Shawn Rabbani, DPM

Title

Medical Director

Phone

(818) 774-1309

Specialties & licenses 1

Addresses

Other names 1

• Prime Surgical Center, Inc. Former legal business name

Locations

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1285365437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18909 SHERMAN WAY",
            "address_2": "SUITE C",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356184",
            "telephone_number": "818-774-1309",
            "fax_number": "818-774-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18909 SHERMAN WAY",
            "address_2": "SUITE C",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356184",
            "telephone_number": "818-774-1309",
            "fax_number": "818-774-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE OUTPATIENT SURGICAL INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "RABBANI",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-774-1309",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Surgical Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Reseda, CA
• Providers in Reseda, 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 Sep 26, 2022; 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.