Provider Demographics
NPI:1982965612
Name:SKYPARK SURGERY CENTER LLC
Entity type:Organization
Organization Name:SKYPARK SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-625-2694
Mailing Address - Street 1:23441 MADISON ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4725
Mailing Address - Country:US
Mailing Address - Phone:213-617-9194
Mailing Address - Fax:213-617-0605
Practice Address - Street 1:23441 MADISON ST STE 115
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4725
Practice Address - Country:US
Practice Address - Phone:424-247-2206
Practice Address - Fax:213-617-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-29
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical