Provider Demographics
NPI:1235471277
Name:PREMIER PEDIATRICS BEVERLY HILLS
Entity Type:Organization
Organization Name:PREMIER PEDIATRICS BEVERLY HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-247-8687
Mailing Address - Street 1:8907 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1937
Mailing Address - Country:US
Mailing Address - Phone:310-247-8687
Mailing Address - Fax:310-859-9131
Practice Address - Street 1:8907 WILSHIRE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1937
Practice Address - Country:US
Practice Address - Phone:310-247-8687
Practice Address - Fax:310-859-9131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43870208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty