Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Source Surgery Center LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1558802249

Source Surgery Center LLC is an Ambulatory Surgical Clinic/Center in Santa Monica, California. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2801 Wilshire Blvd
Santa Monica, CA 90403-4801
Phone: (310) 574-2777
Fax: (310) 315-4968
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X

Record details

NPI number1558802249
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Davis — Owner · (310) 574-2777
NPI enumeratedMarch 14, 2017
Last updated in NPPESJanuary 21, 2020
Certification dateJanuary 21, 2020
Mailing address1112 Montana Ave, Suite 900, Santa Monica, CA 90403-1652

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