Canaan Surgery Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CANAAN SURGERY CENTER, INC.

Practice address

903 Crenshaw Blvd
Suite 200
Los Angeles, CA 90019-1964

Phone

(323) 909-6644

NPI assigned

Apr 25, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Walter Jung Kim, M.D.

Title

Ceo/Medical Director

Phone

(323) 909-6644

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1407201676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191964",
            "telephone_number": "323-909-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 CRENSHAW BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191964",
            "telephone_number": "323-909-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANAAN SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "JUNG",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-909-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashida Taher Campwala, M.D.
• Erin Camron, N.P.
• Can DO Kids Inc
• Canaan Medical Supply, Inc.
• Canaan Pharmacy
• Whitney Canady
• Amy Guadalupe Canal, BA
• Cinzia Canale Fossa, M.A.
• Flor De Maria Canales Cucho
• Cecilia Canales, MD. MPH

• Ambulatory Surgical Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, 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 25, 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.