MEDICARE: BEVERLY HILLS AMBULATORY SURGERY CENTER LLC

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	:	1427316868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY HILLS AMBULATORY SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	50 N LA CIENEGA BLVD
Second Line	:	150
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2227
Country	:	US
Telephone Number	:	323-988-3848
Fax Number	:	323-988-2113

Provider Business Practice Location Address
First Line	:	50 N LA CIENEGA BLVD
Second Line	:	150
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3143
Country	:	US
Telephone Number	:	323-988-3848
Fax Number	:	323-988-2113

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. SCHLOMO SCHMUEL
Credential	:	DPM
Telephone Number	:	213-483-4246

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	02/13/2014

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