Healthcare Provider Details

I. General information

NPI: 1194959809
Provider Name (Legal Business Name): BEVERLY HILLS REGIONAL SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S BEVERLY DR SUITE 505
LOS ANGELES CA
90035-1148
US

IV. Provider business mailing address

1125 S BEVERLY DR SUITE 505
LOS ANGELES CA
90035-1148
US

V. Phone/Fax

Practice location:
  • Phone: 310-556-4600
  • Fax:
Mailing address:
  • Phone: 310-301-8329
  • 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. ISAAC VERBUKH
Title or Position: OWNER
Credential: M.D.
Phone: 310-301-8329