Healthcare Provider Details

I. General information

NPI: 1265941561
Provider Name (Legal Business Name): BEVERLY HILLS TMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8484 WILSHIRE BLVD STE 200
BEVERLY HILLS CA
90211-3235
US

IV. Provider business mailing address

1801 CENTURY PARK E STE 2240
LOS ANGELES CA
90067-2324
US

V. Phone/Fax

Practice location:
  • Phone: 310-360-7690
  • Fax:
Mailing address:
  • Phone: 424-488-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG60783
License Number State

VIII. Authorized Official

Name: SAM DEKIN
Title or Position: CEO
Credential:
Phone: 760-641-3972