Healthcare Provider Details

I. General information

NPI: 1063179570
Provider Name (Legal Business Name): DOHENY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 BURTON WAY
BEVERLY HILLS CA
90211-1661
US

IV. Provider business mailing address

9090 BURTON WAY
BEVERLY HILLS CA
90211-1661
US

V. Phone/Fax

Practice location:
  • Phone: 310-205-0111
  • Fax: 310-299-3939
Mailing address:
  • Phone: 310-205-0111
  • Fax: 310-299-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DANIEL BEHROOZAN
Title or Position: DIRECTOR
Credential: MD
Phone: 310-205-0111