Healthcare Provider Details

I. General information

NPI: 1821992561
Provider Name (Legal Business Name): BEVERLY HILLS SURGICAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 BIRCH ST STE A
NEWPORT BEACH CA
92660-1928
US

IV. Provider business mailing address

453 S SPRING ST STE 400
LOS ANGELES CA
90013-2074
US

V. Phone/Fax

Practice location:
  • Phone: 310-299-9809
  • Fax: 310-299-9835
Mailing address:
  • Phone: 310-299-9809
  • Fax: 310-299-9835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GRAHAM IVES
Title or Position: CEO
Credential: MD
Phone: 310-299-9809