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General NPI Number Information
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NPI Number | 1073044608
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Entity Type | Organization
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Legal Business Name | PLATINUM SURGICAL CENTER
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 465 N ROXBURY DR STE 1017
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4213
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Country | US
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Telephone | 310-993-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 465 N ROXBURY DR STE 1017
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4213
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Country | US
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Telephone | 310-993-3800
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DARIA ANDREYEVA
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Credential |
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Telephone | 310-993-3800
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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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