Healthcare Provider Details

I. General information

NPI: 1891062113
Provider Name (Legal Business Name): ROXBURY SURGICAL CENTER LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2011
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 NORTH ROXBURY DRIVE 200
BEVERLY HILLS CA
90210
US

IV. Provider business mailing address

311 NORTH ROBERTSON BLVD.
BEVERLY HILLS CA
90211
US

V. Phone/Fax

Practice location:
  • Phone: 310-247-9090
  • Fax:
Mailing address:
  • Phone: 310-247-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA61184
License Number StateCA

VIII. Authorized Official

Name: DR. DARYOUSH SAADAT
Title or Position: OWNER/ DOCTOR
Credential: MD
Phone: 310-247-9090