Provider Demographics
NPI:1215668546
Name:INTUITIVE SURGERY CENTER, INC.
Entity type:Organization
Organization Name:INTUITIVE SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN, GOVERNING BODY
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-338-6860
Mailing Address - Street 1:317 S BRAND BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1701
Mailing Address - Country:US
Mailing Address - Phone:818-338-6860
Mailing Address - Fax:
Practice Address - Street 1:317 S BRAND BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1701
Practice Address - Country:US
Practice Address - Phone:818-338-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical