Provider Demographics
NPI:1316082365
Name:WEST WILSHIRE MEDICAL SURGICAL CENTER INC.
Entity type:Organization
Organization Name:WEST WILSHIRE MEDICAL SURGICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-477-5558
Mailing Address - Street 1:11645 WILSHIRE BLVD
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1708
Mailing Address - Country:US
Mailing Address - Phone:310-477-5558
Mailing Address - Fax:310-477-7281
Practice Address - Street 1:11645 WILSHIRE BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1708
Practice Address - Country:US
Practice Address - Phone:310-477-5558
Practice Address - Fax:310-477-7281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS051570261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051570Medicare ID - Type Unspecified