Organization Active NPI

United Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Montebello, CA
National Provider Identifier
1639214778
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
930000995 Issued in CA
Legal business name
UNITED SURGERY CENTER
Practice address
128 S Montebello Blvd
Montebello, CA 90640-4730
Phone
(323) 720-9204
Fax
(323) 720-9208
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Authorized official

Name
Mr. Alexander Yacoub
Title
Billing Office Manager
Phone
(323) 720-9204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 930000995 CA Primary

Addresses

Primary practice location

128 S Montebello Blvd
Montebello, CA 90640-4730

Mailing address

128 S Montebello Blvd
Montebello, CA 90640-4730
Phone (323) 720-9204

Other identifiers 1

IdentifierTypeStateIssuer
SUR01603FMedicaidCA

National Provider Directory

National Provider Directory

Locations

128 S Montebello Blvd
Montebello, CA 90640
Phone (323) 726-0577

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1639214778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 S MONTEBELLO BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404730",
            "telephone_number": "323-720-9204",
            "fax_number": "323-720-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S MONTEBELLO BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404730",
            "telephone_number": "323-720-9204",
            "fax_number": "323-720-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "YACOUB",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "BILLING OFFICE MANAGER",
        "authorized_official_telephone_number": "323-720-9204",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "930000995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01603F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.