MEDICARE: BH OUTPATIENT SURGICAL CENTER

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	:	1609492040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BH OUTPATIENT SURGICAL CENTER

Provider Business Mailing Address
First Line	:	324 S BEVERLY DR STE 173
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 N LA CIENEGA BLVD STE 110
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2339
Country	:	US
Telephone Number	:	424-230-3557
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	MR. ADAM SILVER
Credential	:
Telephone Number	:	424-230-3557

Provider Enumeration Date	:	06/22/2020
Last Update Date	:	06/22/2020

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