Organization Active NPI

Museum Center Surgery Group Inc.

Doing business as Miracle Mile Outpatient Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1417950197
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
930000897 Issued in CA
Legal business name
MUSEUM CENTER SURGERY GROUP INC.
Doing business as
Miracle Mile Outpatient Surgery Center
Practice address
5757 Wilshire Blvd
Promenade 6
Los Angeles, CA 90036-3681
Phone
(323) 964-0866
Fax
(323) 964-0868
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Dr. Howard Stanley Rubin, PHD
Title
Chief Executive Officer
Phone
(323) 964-0866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 930000897 CA Primary

Addresses

Primary practice location

5757 Wilshire Blvd
Promenade 6
Los Angeles, CA 90036-3681

Mailing address

5757 Wilshire Blvd
Promenade 6
Los Angeles, CA 90036-3681
Phone (323) 964-0866

Other names 1

  • Miracle Mile Outpatient Surgery Center Doing business as

National Provider Directory

National Provider Directory

Locations

5757 Wilshire Blvd
#6
Los Angeles, CA 90036
Phone (310) 657-6993

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1417950197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD",
            "address_2": "PROMENADE 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363681",
            "telephone_number": "323-964-0866",
            "fax_number": "323-964-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD",
            "address_2": "PROMENADE 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363681",
            "telephone_number": "323-964-0866",
            "fax_number": "323-964-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSEUM CENTER SURGERY GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-964-0866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "930000897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle Mile Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.