Healthcare Provider Details

I. General information

NPI: 1235471277
Provider Name (Legal Business Name): PREMIER PEDIATRICS BEVERLY HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2013
Last Update Date: 03/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8907 WILSHIRE BLVD SUITE 250
BEVERLY HILLS CA
90211-1937
US

IV. Provider business mailing address

8907 WILSHIRE BLVD SUITE 250
BEVERLY HILLS CA
90211-1937
US

V. Phone/Fax

Practice location:
  • Phone: 310-247-8687
  • Fax: 310-859-9131
Mailing address:
  • Phone: 310-247-8687
  • Fax: 310-859-9131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA43870
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL SACHS
Title or Position: C.E.O
Credential: M.D.
Phone: 310-247-8687