Healthcare Provider Details

I. General information

NPI: 1275911489
Provider Name (Legal Business Name): HSU BEVERLY HILLS SURGERY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 WILSHIRE BLVD 100
LOS ANGELES CA
90010-1824
US

IV. Provider business mailing address

3350 WILSHIRE BLVD 100
LOS ANGELES CA
90010-1824
US

V. Phone/Fax

Practice location:
  • Phone: 213-383-3322
  • Fax: 213-383-1667
Mailing address:
  • Phone: 213-383-3322
  • Fax: 213-383-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA84401
License Number StateCA

VIII. Authorized Official

Name: DR. CHARLES S HSU
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 310-888-2228