Healthcare Provider Details

I. General information

NPI: 1093893265
Provider Name (Legal Business Name): BEVERLY HILLS BARIATRIC INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 WILSHIRE BLVD STE 501
BEVERLY HILLS CA
90211-1949
US

IV. Provider business mailing address

PO BOX 5754
BEVERLY HILLS CA
90209-5754
US

V. Phone/Fax

Practice location:
  • Phone: 310-914-9105
  • Fax: 310-914-9705
Mailing address:
  • Phone: 310-914-9150
  • Fax: 310-914-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA42738
License Number StateCA

VIII. Authorized Official

Name: JAMSHID NAZARIAN
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 310-914-9150