Provider Demographics
NPI:1235572421
Name:BEVERLY HILLS PENTHOUSE ANESTHESIA SERVICES, INC
Entity Type:Organization
Organization Name:BEVERLY HILLS PENTHOUSE ANESTHESIA SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEFFLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-573-5100
Mailing Address - Street 1:8929 WILSHIRE BLVD
Mailing Address - Street 2:PENTHOUSE STE
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1938
Mailing Address - Country:US
Mailing Address - Phone:714-396-8777
Mailing Address - Fax:
Practice Address - Street 1:8929 WILSHIRE BLVD
Practice Address - Street 2:PENTHOUSE STE
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1938
Practice Address - Country:US
Practice Address - Phone:714-396-8777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC354205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty