Provider Demographics
NPI:1023829447
Name:SEA SURGICAL INSTITUTE LLC
Entity type:Organization
Organization Name:SEA SURGICAL INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:818-855-1507
Mailing Address - Street 1:6789 QUAIL HILL PARKWAY
Mailing Address - Street 2:STE 102
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-9264
Mailing Address - Country:US
Mailing Address - Phone:818-855-1507
Mailing Address - Fax:
Practice Address - Street 1:7801 CENTER AVE STE 102
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-9112
Practice Address - Country:US
Practice Address - Phone:818-855-1507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical