MEDICARE: BEVERLY HILLS SURGICAL INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1407416597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY HILLS SURGICAL INSTITUTE

Provider Business Mailing Address
First Line	:	9025 WILSHIRE BLVD STE 201
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9025 WILSHIRE BLVD STE 201
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1825
Country	:	US
Telephone Number	:	833-364-6362
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KAREN SHAI
Credential	:
Telephone Number	:	833-364-6362

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	06/19/2019

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