NPIMap

Organization Active NPI

Miracle Mile Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1972201812
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MIRACLE MILE SURGERY CENTER
Practice address
5757 Wilshire Blvd Ste 6
Los Angeles, CA 90036-5810
Phone
(323) 433-7744
NPI assigned
Feb 20, 2023
Last updated
Feb 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Shahbaz Farnad, MDNPI 1992080618
Title
President
Phone
(323) 433-7744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

5757 Wilshire Blvd Ste 6
Los Angeles, CA 90036-5810

Mailing address

5757 Wilshire Blvd Ste 6
Los Angeles, CA 90036-5810
Phone (323) 433-7744

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1972201812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD STE 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-433-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD STE 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-433-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE MILE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "FARNAD",
        "authorized_official_first_name": "SHAHBAZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-433-7744",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.