Provider Demographics
NPI:1427692037
Name:BIOHEALTH SURGICAL INSTITUTE
Entity type:Organization
Organization Name:BIOHEALTH SURGICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMLOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-246-2358
Mailing Address - Street 1:1451 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2711
Mailing Address - Country:US
Mailing Address - Phone:310-246-2358
Mailing Address - Fax:424-285-8534
Practice Address - Street 1:1451 BROADWAY
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2711
Practice Address - Country:US
Practice Address - Phone:310-246-2358
Practice Address - Fax:424-285-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical