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General NPI Number Information
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NPI Number | 1205968070
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS SUNSET SURGERY CENTER, INC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 9201 W SUNSET BLVD SUITE 405
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City | LOS ANGELES
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State | CA
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Zip | 90069-3701
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Country | US
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Telephone | 310-887-1730
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Fax | 310-887-1734
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Provider Business Mailing Address
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Address Line | 9201 W. SUNSET BLVD STE 405
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City | LOS ANGELES
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State | CA
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Zip | 90069
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Country | US
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Telephone | 310-887-1730
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Fax | 310-887-1734
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | RICHARD MATLOCK
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Credential |
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Telephone | 310-887-1730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | S051348
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License Number State | CA
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