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General NPI Number Information
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NPI Number | 1528572559
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Entity Type | Organization
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Legal Business Name | BEACON SURGICAL CENTER, LLC.
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 414 N CAMDEN DR FL 8
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4532
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Country | US
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Telephone | 310-488-0776
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Fax |
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD STE 628
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-488-0776
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JAMES NASSIRI
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Credential | MD
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Telephone | 310-488-0776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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