Healthcare Provider Details

I. General information

NPI: 1225179898
Provider Name (Legal Business Name): EYE SURGERY CENTER OF BEVERLY HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S LA CIENEGA BLVD STE 260
BEVERLY HILLS CA
90211-3324
US

IV. Provider business mailing address

240 S LA CIENEGA BLVD STE 260
BEVERLY HILLS CA
90211-3324
US

V. Phone/Fax

Practice location:
  • Phone: 310-289-6595
  • Fax: 310-423-9647
Mailing address:
  • Phone: 310-289-6595
  • Fax: 310-423-9647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA44942
License Number StateCA

VIII. Authorized Official

Name: YARON S RABINOWITZ
Title or Position: PRESIDENT
Credential: MD
Phone: 310-423-9640