Healthcare Provider Details

I. General information

NPI: 1508371600
Provider Name (Legal Business Name): BH VEIN INSTITUTE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 BRIGHTON WAY STE 205
BEVERLY HILLS CA
90210-4709
US

IV. Provider business mailing address

9663 SANTA MONICA BLVD PMB 749
BEVERLY HILLS CA
90210-4303
US

V. Phone/Fax

Practice location:
  • Phone: 310-853-5850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberA065321
License Number StateCA

VIII. Authorized Official

Name: DR. IVAN BROOKS
Title or Position: PRESIDENT
Credential: MD
Phone: 310-853-5850