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General NPI Number Information
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NPI Number | 1881578656
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Entity Type | Organization
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Legal Business Name | SPINE SURGEON MD PC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 8500 WILSHIRE BLVD STE 1018
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3108
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Country | US
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Telephone | 424-377-7463
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Fax |
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Provider Business Mailing Address
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Address Line | 8500 WILSHIRE BLVD STE 1018
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3108
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Country | US
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Telephone | 424-377-7463
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Fax |
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Authorized Official
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Title or Position | SPINE SURGEON
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Name | ALEXANDER GHASEM
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Credential | MD
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Telephone | 424-377-7463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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