Clover Surgical Center, Inc., a California Corporation

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CLOVER SURGICAL CENTER, INC., A CALIFORNIA CORPORATION

Practice address

12134 Victory Blvd
Suite E
North Hollywood, CA 91606-3205

Phone

(818) 762-8702

Fax

(818) 761-2583

NPI assigned

Feb 18, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Mitchell Paul Rubin

Title

Administrator

Phone

(818) 415-3205

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1619368248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 VICTORY BLVD",
            "address_2": "SUITE E",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063205",
            "telephone_number": "818-762-8702",
            "fax_number": "818-761-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12134 VICTORY BLVD",
            "address_2": "SUITE E",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063205",
            "telephone_number": "818-762-8702",
            "fax_number": "818-761-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER SURGICAL CENTER, INC., A CALIFORNIA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-415-3205",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in North Hollywood, CA
• Providers in North Hollywood, 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 18, 2015; 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.