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General NPI Number Information
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NPI Number | 1518127281
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Entity Type | Organization
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Legal Business Name | GLAUCOMA INSTITUTE OF BEVERLY HILLS
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 8733 BEVERLY BOULEVARD SUITE 301
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City | LOS ANGELES
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State | CA
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Zip | 90048-1800
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Country | US
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Telephone | 310-855-1112
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Fax | 310-855-1211
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Provider Business Mailing Address
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Address Line | 8733 BEVERLY BOULEVARD SUITE 301
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City | LOS ANGELES
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State | CA
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Zip | 90048-1800
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Country | US
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Telephone | 310-855-1112
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Fax | 310-855-1211
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL S BERLIN
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Credential | MD
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Telephone | 310-855-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G31961
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License Number State | CA
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