Healthcare Provider Details

I. General information

NPI: 1073295150
Provider Name (Legal Business Name): BEVERLY CAMDEN SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N CAMDEN DR STE 735
BEVERLY HILLS CA
90210-4411
US

IV. Provider business mailing address

433 N CAMDEN DR STE 735
BEVERLY HILLS CA
90210-4411
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-5954
  • Fax:
Mailing address:
  • Phone: 310-271-5954
  • Fax:

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. CHARLES S LEE
Title or Position: OWNER
Credential: MD
Phone: 310-271-5954