Healthcare Provider Details

I. General information

NPI: 1023039682
Provider Name (Legal Business Name): BEVERLY HILLS ENDOSCOPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 03/22/2024
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 WILSHIRE BLVD STE 320
BEVERLY HILLS CA
90211-2003
US

IV. Provider business mailing address

8920 WILSHIRE BLVD STE 320
BEVERLY HILLS CA
90211-2003
US

V. Phone/Fax

Practice location:
  • Phone: 310-888-8898
  • Fax: 310-888-8814
Mailing address:
  • Phone: 310-888-8898
  • Fax: 310-888-8814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. SORAYA ROSS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 310-888-8898