Provider Demographics
NPI:1063209195
Name:ADVANCED SURGICAL ASSOCIATES OF SANTA MONICA
Entity type:Organization
Organization Name:ADVANCED SURGICAL ASSOCIATES OF SANTA MONICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-828-2212
Mailing Address - Street 1:2001 SANTA MONICA BLVD STE 1170W
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2122
Mailing Address - Country:US
Mailing Address - Phone:310-828-2212
Mailing Address - Fax:
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 1170W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2122
Practice Address - Country:US
Practice Address - Phone:310-828-2212
Practice Address - Fax:310-828-6829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty