Healthcare Provider Details
I. General information
NPI: 1629854005
Provider Name (Legal Business Name): HALO BEVERLY HILLS SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2023
Last Update Date: 09/01/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
433 N CAMDEN DR STE 960 SUITE 960
BEVERLY HILLS CA
90210
US
IV. Provider business mailing address
433 N CAMDEN DR STE 960 SUITE 960
BEVERLY HILLS CA
90210
US
V. Phone/Fax
- Phone: 310-772-0755
- Fax: 310-772-0744
- Phone: 310-772-0755
- Fax: 310-772-0744
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.
DONALD
YOO
Title or Position: MANAGER
Credential: M.D.
Phone: 310-772-0766