Healthcare Provider Details

I. General information

NPI: 1467880245
Provider Name (Legal Business Name): PREMIER SURGERY CENTER OF BEVERLY HILLS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 N LA CIENEGA BLVD SUITE 106
BEVERLY HILLS CA
90211-2222
US

IV. Provider business mailing address

99 N LA CIENEGA BLVD SUITE 106
BEVERLY HILLS CA
90211-2222
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-4100
  • Fax:
Mailing address:
  • Phone: 310-652-4100
  • 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: OSCAR LEAL
Title or Position: OWNER
Credential:
Phone: 310-652-4100