Healthcare Provider Details

I. General information

NPI: 1992683429
Provider Name (Legal Business Name): MEDSURGICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 N LA CIENEGA BLVD STE 109
BEVERLY HILLS CA
90211-2286
US

IV. Provider business mailing address

99 N LA CIENEGA BLVD STE 109
BEVERLY HILLS CA
90211-2286
US

V. Phone/Fax

Practice location:
  • Phone: 310-683-7536
  • Fax:
Mailing address:
  • Phone:
  • 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. ALEXANDER GHATAN
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 855-786-7846