Provider Demographics
NPI:1952628166
Name:SURGI ART INC
Entity Type:Organization
Organization Name:SURGI ART INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NEAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-858-8811
Mailing Address - Street 1:9615 BRIGHTON WAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5131
Mailing Address - Country:US
Mailing Address - Phone:310-858-8811
Mailing Address - Fax:310-858-8282
Practice Address - Street 1:9615 BRIGHTON WAY
Practice Address - Street 2:SUITE 303
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5131
Practice Address - Country:US
Practice Address - Phone:310-858-8811
Practice Address - Fax:310-858-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99678208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty