Provider Demographics
NPI:1093254146
Name:BEVERLY HILLS MEDICAL CENTER FOR COSMETIC SURGERY INC
Entity Type:Organization
Organization Name:BEVERLY HILLS MEDICAL CENTER FOR COSMETIC SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-777-2627
Mailing Address - Street 1:9735 WILSHIRE BLVD
Mailing Address - Street 2:220
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2107
Mailing Address - Country:US
Mailing Address - Phone:310-777-2627
Mailing Address - Fax:310-777-2632
Practice Address - Street 1:9735 WILSHIRE BLVD
Practice Address - Street 2:220
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2107
Practice Address - Country:US
Practice Address - Phone:310-777-2627
Practice Address - Fax:310-777-2632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Single Specialty