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General NPI Number Information
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NPI Number | 1740020833
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Entity Type | Organization
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Legal Business Name | ELITE DIGESTIVE HEALTH INC.
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 9454 WILSHIRE BLVD STE 510
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2904
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Country | US
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Telephone | 310-922-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 2355 WESTWOOD BLVD # 868
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City | LOS ANGELES
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State | CA
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Zip | 90064-2109
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Country | US
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Telephone | 310-922-2613
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Fax |
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Authorized Official
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Title or Position | MD/CEO
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Name | DR. BENJAMIN BASSERI
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Credential | MD
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Telephone | 310-922-2613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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