Healthcare Provider Details

I. General information

NPI: 1205983889
Provider Name (Legal Business Name): NACH SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N ROXBURY DR SUITE 207
BEVERLY HILLS CA
90210-5027
US

IV. Provider business mailing address

435 N ROXBURY DR SUITE 207
BEVERLY HILLS CA
90210-5027
US

V. Phone/Fax

Practice location:
  • Phone: 310-858-4493
  • Fax: 310-858-4497
Mailing address:
  • Phone: 310-858-4493
  • Fax: 310-858-4497

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. RAPHAEL NACH
Title or Position: PRESIDENT
Credential: MD
Phone: 310-858-4493