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PREMIER SURGICAL PAVILION OF LA
NPI 1114589793
Clinic/Center - Ambulatory Surgical in Los Angeles, CA

Active since July 03, 2019
11661 SAN VICENTE BLVD, LOS ANGELES, CA 90049(212) 223-0716 Get Directions Write a Review

NPPES record last updated: July 3, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Premier Surgical Pavilion Of La NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIER SURGICAL PAVILION OF LA (NPI 1114589793) is a healthcare organization registered as an ambulatory surgical in Los Angeles, California and active in the NPI registry since July 2019. The organization lists Michael Eugene Jones, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1114589793
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NamePREMIER SURGICAL PAVILION OF LA
Location Address11661 SAN VICENTE BLVDLos Angeles, CA 90049-5103
Mailing Address115 E 39th StNew York, NY 10016-0943 · (212) 223-0716
Phone(212) 223-0716
Organization SubpartNo
Authorized OfficialMichael Eugene JonesMedical Director · (212) 223-0716
Enumeration DateJuly 3, 2019
✔ NPI 1114589793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
11661 SAN VICENTE BLVD, Los Angeles, CA 90049
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Other Identifiers 1

OtherC53266CA · Medical License

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY ROWNAGHI FNP
Nurse Practitioner (Family)
11661 SAN VICENTE BLVD, #101
LOS ANGELES, CA 90049
Los Angeles County (310) 312-1231
DR. JOCELYN CAROL STAMAT M.D.
Otolaryngology
11661 SAN VICENTE BLVD, SUITE 101
LOS ANGELES, CA 90049
Los Angeles County (310) 826-2030
DR. AARON HUNTER SONES M.D.
Independent Medical Examiner
11661 SAN VICENTE BLVD, 1035
LOS ANGELES, CA 90049
Los Angeles County (310) 471-2814
BONNIE BANAFSHE SHAYEG M.A.
Marriage & Family Therapist
11661 SAN VICENTE BLVD
LOS ANGELES, CA 90049
Los Angeles County (424) 234-9955
JEANNINE NAHABEDIAN
Physician Assistant
11661 SAN VICENTE BLVD, 101
LOS ANGELES, CA 90049
Los Angeles County (310) 312-1231

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premier Surgical Pavilion Of La's NPI number?

The NPI number for Premier Surgical Pavilion Of La is 1114589793. It was assigned to this organization in the NPPES registry on July 3, 2019.

Where is Premier Surgical Pavilion Of La located?

Premier Surgical Pavilion Of La is located at 11661 San Vicente Blvd, Los Angeles, CA 90049. The listed phone number is (212) 223-0716.

What is Premier Surgical Pavilion Of La's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

When was this NPI record last updated?

The NPPES record for Premier Surgical Pavilion Of La was last updated on July 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.