Pivac ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PIVAC ASC LLC

Practice address

6076 Bristol Pkwy
Suite 108
Culver City, CA 90230-6600

Phone

(310) 348-9604

NPI assigned

Jan 31, 2017

Organization subpart

No

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

Authorized official

Name

Spencer L. Brown, M.D.

Title

Medical Director

Phone

(310) 348-9604

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Pacific Interventional Vascular Access CenterCCN 05C0002186

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Pacific Interventional Vascular Access Center Medical Corporation

  • Vascular & Interventional Radiology Physician
  • Culver City, CA
  • NPI 1942593918

  Member Of

  NPD member

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1679010417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 VALLEY STREAM PKWY",
            "address_2": "SUITE 100",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6076 BRISTOL PKWY",
            "address_2": "SUITE 108",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306600",
            "telephone_number": "310-348-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIVAC ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-348-9604",
        "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": []
}

• Michael Anthony Piombo
• Xenia Breanna Piril
• Kathleen M Pittman, OTR
• Reshona L Pitts, LMFT
• Shameka Monee Pitts
• Alessandra Planera, OT
• Playa Vista Marriage & Family Therapy, Inc.
• Ruben Lionel Plaza Jr.
• Lisa M Plocher, CNP
• Boris Plotkin, SLP

• Ambulatory Surgical Clinic/Center in Culver City, CA
• Providers in Culver City, 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 Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.