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General NPI Number Information
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NPI Number | 1053593756
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Entity Type | Organization
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Legal Business Name | BRIGHTON MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 9400 BRIGHTON WAY SUITE 401
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City | BEVERLY HILLS
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State | CA
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Zip | 90210
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Country | US
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Telephone | 310-276-9071
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Fax | 310-276-9074
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD SUITE 644
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-276-9071
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Fax | 310-289-8205
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. SHAWN NASSERI
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Credential | M.D.
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Telephone | 310-729-3116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | CA
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