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General NPI Number Information
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NPI Number | 1053719773
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS SURGICAL & MEDICAL CENTER
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 8500 WILSHIRE BLVD STE 1020
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3108
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Country | US
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Telephone | 310-360-0504
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Fax |
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Provider Business Mailing Address
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Address Line | 8500 WILSHIRE BLVD STE 1020
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3108
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Country | US
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Telephone | 310-360-0504
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. FARDAD FOROUZANPOUR
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Credential | DO
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Telephone | 310-360-0504
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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 | 2OA7188
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License Number State | CA
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