Healthcare Provider Details

I. General information

NPI: 1821732306
Provider Name (Legal Business Name): HOAG ORTHOPEDIC INSTITUTE SURGERY CENTER BEVERLY HILLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 WILSHIRE BLVD STE 102
BEVERLY HILLS CA
90211-1848
US

IV. Provider business mailing address

9090 WILSHIRE BLVD STE 102
BEVERLY HILLS CA
90211-1848
US

V. Phone/Fax

Practice location:
  • Phone: 949-517-3375
  • Fax:
Mailing address:
  • Phone: 310-210-8679
  • 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: TINA NGUYEN
Title or Position: DIRECTOR BUSINESS OPERATIONS
Credential:
Phone: 949-517-3375