Healthcare Provider Details
I. General information
NPI: 1447712831
Provider Name (Legal Business Name): BEVERLY HILLS SPECIALTY SURGICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2019
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8929 WILSHIRE BLVD STE 415
BEVERLY HILLS CA
90211-1953
US
IV. Provider business mailing address
8929 WILSHIRE BLVD PH
BEVERLY HILLS CA
90211-1954
US
V. Phone/Fax
- Phone: 424-512-1901
- Fax:
- Phone: 424-512-1901
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
RAHAL
Title or Position: OWNER
Credential:
Phone: 424-512-1901