Healthcare Provider Details

I. General information

NPI: 1154873560
Provider Name (Legal Business Name): LUXE SURGERY CENTER, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 N BEDFORD DR SUITE 210
BEVERLY HILLS CA
90210-4322
US

IV. Provider business mailing address

416 N BEDFORD DR SUITE 210
BEVERLY HILLS CA
90210-4322
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-3663
  • Fax:
Mailing address:
  • Phone: 310-276-3663
  • 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. BRUCE KADZ
Title or Position: CHAIRMAN, GOVERNING BODY
Credential: M.D.
Phone: 310-276-3662