Lax Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAX SURGERY CENTER LLC

Practice address

5450 Lincoln Blvd # 100
Playa Vista, CA 90094-2002

Phone

(310) 305-9200

NPI assigned

Feb 3, 2021

Organization subpart

No

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

Authorized official

Name

Samson Yirgu

Title

Administrator

Phone

(323) 500-7809

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1457943243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY # 574",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-305-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 LINCOLN BLVD # 100",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942002",
            "telephone_number": "310-305-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAX SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "YIRGU",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-500-7809"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iana Kazantseva
• Katherine Patricia Kempf, MD
• Aletta Kennedy, MS, RD
• Christine A Lam, MD
• Lax Medical Group, Inc
• Elena Lee, PHARMD
• Veronica Ann Lewis, NP
• Zheng Li
• Life Worth Living Therapy,a Licensed Marriage and Family Therapist,Inc
• Sarah Mahmood, MD

• Ambulatory Surgical Clinic/Center in Playa Vista, CA
• Providers in Playa Vista, 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 Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.