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General NPI Number Information
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NPI Number | 1659861722
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS BREAST CENTER INC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 9090 BURTON WAY
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City | BEVERLY HILLS
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State | CA
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Zip | 90211
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Country | US
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Telephone | 310-855-3960
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Fax | 310-382-2422
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Provider Business Mailing Address
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Address Line | PO BOX 1325
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-1325
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Country | US
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Telephone | 310-855-3960
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Fax | 310-382-2422
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Authorized Official
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Title or Position | PLASTIC SURGEON
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Name | PERRY H LIU
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Credential | MD
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Telephone | 310-855-3960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A96604
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License Number State | CA
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