Healthcare Provider Details
I. General information
NPI: 1467037705
Provider Name (Legal Business Name): HM SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
436 N ROXBURY DR STE 117
BEVERLY HILLS CA
90210-5016
US
IV. Provider business mailing address
3972 BARRANCA PKWY STE J
IRVINE CA
92606-8291
US
V. Phone/Fax
- Phone: 310-853-0502
- Fax: 866-439-4879
- Phone: 949-371-9862
- Fax: 866-439-4879
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: DR.
MARCO
M
ZAHEDI
Title or Position: OWNER
Credential: MD
Phone: 310-853-0502