Healthcare Provider Details

I. General information

NPI: 1730836388
Provider Name (Legal Business Name): PH MULTISPECIALTY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 WILSHIRE BLVD STE 400
BEVERLY HILLS CA
90211-1953
US

IV. Provider business mailing address

8929 WILSHIRE BLVD STE 400
BEVERLY HILLS CA
90211-1953
US

V. Phone/Fax

Practice location:
  • Phone: 424-274-2363
  • Fax:
Mailing address:
  • Phone: 424-274-2363
  • 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: DR. JONATHON SYKES
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 424-274-2363