Healthcare Provider Details

I. General information

NPI: 1033258462
Provider Name (Legal Business Name): CRH CLINIC OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N LA CIENEGA BLVD SUITE 310
BEVERLY HILLS CA
90211-2227
US

IV. Provider business mailing address

50 N LA CIEGNA SUITE 310
BEVERLY HILLS CA
90211
US

V. Phone/Fax

Practice location:
  • Phone: 310-358-9404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BEAR
Title or Position: CFO
Credential:
Phone: 604-633-1440