Bambu Skin and Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BAMBU SKIN AND SURGERY CENTER LLC

Practice address

16101 Ventura Blvd Ste 240
Encino, CA 91436-2513

Phone

(310) 779-3025

NPI assigned

Apr 4, 2019

Organization subpart

No

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

Authorized official

Name

Christy Davis

Title

President

Phone

(310) 779-3025

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1902368293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD STE 240",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD STE 240",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362513",
            "telephone_number": "310-779-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAMBU SKIN AND SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-779-3025"
    },
    "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 Encino, CA
• Providers in Encino, 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 Apr 4, 2019; 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.