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General NPI Number Information
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NPI Number | 1407327356
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Entity Type | Organization
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Legal Business Name | ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 8750 WILSHIRE BLVD STE 150
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2725
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Country | US
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Telephone | 408-761-5847
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Fax |
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Provider Business Mailing Address
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Address Line | 1871 MARTIN AVE
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City | SANTA CLARA
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State | CA
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Zip | 95050-2501
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Country | US
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Telephone | 408-761-5847
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Fax | 408-899-6155
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Authorized Official
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Title or Position | VP OF CLINICAL OPERATIONS
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Name | BARBARA LEE ROTH
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Credential | REGISTERED NURSE
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Telephone | 408-761-5847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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