Provider Demographics
NPI:1639195035
Name:BEVERLY HILLS AESTHETIC SURGICAL INSTITUTE INC.
Entity Type:Organization
Organization Name:BEVERLY HILLS AESTHETIC SURGICAL INSTITUTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYOUSH
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SAADAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-247-9090
Mailing Address - Street 1:435 N ROXBURY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5004
Mailing Address - Country:US
Mailing Address - Phone:310-247-9090
Mailing Address - Fax:310-247-9080
Practice Address - Street 1:311 N ROBERTSON BLVD STE 240
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1705
Practice Address - Country:US
Practice Address - Phone:310-247-9090
Practice Address - Fax:310-247-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA061184174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA061184OtherLICENSE NUMBER
CAH35782Medicare UPIN