Provider Demographics
NPI:1932530250
Name:URGENT CARE OF BEVERLY HILLS & CENTURY CITY
Entity Type:Organization
Organization Name:URGENT CARE OF BEVERLY HILLS & CENTURY CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHROUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GHODSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-552-2273
Mailing Address - Street 1:9884 SANTA MONICA BLVD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1622
Mailing Address - Country:US
Mailing Address - Phone:310-552-2273
Mailing Address - Fax:
Practice Address - Street 1:9884 SANTA MONICA BLVD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1622
Practice Address - Country:US
Practice Address - Phone:310-552-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACR954AMedicare PIN