Healthcare Provider Details

I. General information

NPI: 1497106314
Provider Name (Legal Business Name): BEVERLY APEX SURGERY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 N LINDEN DR SUITE #333
BEVERLY HILLS CA
90212-2247
US

IV. Provider business mailing address

462 N LINDEN DR SUITE #333
BEVERLY HILLS CA
90212-2247
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-5954
  • Fax: 626-331-3204
Mailing address:
  • Phone: 310-271-5954
  • Fax: 626-331-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number5187
License Number StateCA

VIII. Authorized Official

Name: DR. CHARLES LEE
Title or Position: OWNER
Credential: M.D.
Phone: 310-271-5954