Provider Demographics
NPI:1588823413
Name:BEVERLY HILLS SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:BEVERLY HILLS SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MASOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-358-9300
Mailing Address - Street 1:250 S LA CIENEGA BLVD # 100
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3302
Mailing Address - Country:US
Mailing Address - Phone:310-358-9300
Mailing Address - Fax:424-288-4587
Practice Address - Street 1:250 S LA CIENEGA BLVD # 100
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3302
Practice Address - Country:US
Practice Address - Phone:310-358-9300
Practice Address - Fax:424-288-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical