Provider Demographics
NPI:1215594379
Name:PAIN MANAGEMENT AND AESTHETIC SURGERY CENTER IN BEVERLY HILLS
Entity Type:Organization
Organization Name:PAIN MANAGEMENT AND AESTHETIC SURGERY CENTER IN BEVERLY HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUBHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-366-0474
Mailing Address - Street 1:1925 ROYAL AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1925 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4619
Practice Address - Country:US
Practice Address - Phone:818-366-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical