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General NPI Number Information
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NPI Number | 1336976711
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Entity Type | Organization
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Legal Business Name | ARETE GASTROENTEROLOGY SPECIALISTS INC
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 213-510-2500
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Fax | 310-237-1904
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Provider Business Mailing Address
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Address Line | 415 N CAMDEN DR STE 111
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4436
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Country | US
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Telephone | 213-510-2500
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Fax | 310-237-1904
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. F. OTIS STEPHEN
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Credential | MD
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Telephone | 805-738-5595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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