Provider Demographics
NPI:1275911232
Name:BEVERLY HILLS SPECIALTY CARE SURGERY
Entity Type:Organization
Organization Name:BEVERLY HILLS SPECIALTY CARE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-734-7246
Mailing Address - Street 1:371 VAN NESS WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1482
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-874-5394
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 703
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-792-3914
Practice Address - Fax:855-874-5394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical