Healthcare Provider Details

I. General information

NPI: 1871545707
Provider Name (Legal Business Name): BEVERLY HILLS AMBULATORY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N ROXBURY DR STE. 104
BEVERLY HILLS CA
90210-5027
US

IV. Provider business mailing address

435 N ROXBURY DR STE 106
BEVERLY HILLS CA
90210-5027
US

V. Phone/Fax

Practice location:
  • Phone: 310-278-1839
  • Fax:
Mailing address:
  • Phone: 310-278-1839
  • 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. NORMAN SHORR
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 310-278-1839