Provider Demographics
NPI:1497106314
Name:BEVERLY APEX SURGERY CENTER INC.
Entity Type:Organization
Organization Name:BEVERLY APEX SURGERY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-271-5954
Mailing Address - Street 1:462 N LINDEN DR
Mailing Address - Street 2:SUITE #333
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2247
Mailing Address - Country:US
Mailing Address - Phone:310-271-5954
Mailing Address - Fax:626-331-3204
Practice Address - Street 1:462 N LINDEN DR
Practice Address - Street 2:SUITE #333
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2247
Practice Address - Country:US
Practice Address - Phone:310-271-5954
Practice Address - Fax:626-331-3204
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEVERLY APEX SURGERY CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5187261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical