Provider Demographics
NPI:1073295150
Name:BEVERLY CAMDEN SURGERY CENTER INC
Entity Type:Organization
Organization Name:BEVERLY CAMDEN SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-271-5954
Mailing Address - Street 1:433 N CAMDEN DR STE 735
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4411
Mailing Address - Country:US
Mailing Address - Phone:310-271-5954
Mailing Address - Fax:
Practice Address - Street 1:433 N CAMDEN DR STE 735
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4411
Practice Address - Country:US
Practice Address - Phone:310-271-5954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical