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General NPI Number Information
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NPI Number | 1508188913
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS SUNSET MEDICAL GROUP
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 9201 W SUNSET BLVD SUITE M155
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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 | 888-380-1899
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Fax | 626-814-0915
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Provider Business Mailing Address
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Address Line | PO BOX 15427
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City | BEVERLY HILLS
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State | CA
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Zip | 90209-1427
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Country | US
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Telephone | 888-380-1899
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Fax | 626-814-0915
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NICK HOOMAN MASHOUR
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Credential | MD
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Telephone | 888-380-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18539
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 301026
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 493968
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A72007
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G83471
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A25405
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A24640
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A61974
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License Number State | CA
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