Provider Demographics
NPI:1417711557
Name:REXFORD SURGICAL
Entity Type:Organization
Organization Name:REXFORD SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLSHANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-367-6763
Mailing Address - Street 1:9301 WILSHIRE BLVD STE 401A
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5424
Mailing Address - Country:US
Mailing Address - Phone:310-274-3481
Mailing Address - Fax:310-274-3482
Practice Address - Street 1:9301 WILSHIRE BLVD STE 401A
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5424
Practice Address - Country:US
Practice Address - Phone:310-274-3481
Practice Address - Fax:310-274-3482
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REXFORD SURGICAL INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty