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NPI 1922323849

NPI 1922323849 : ROXBURY BEVERLY HILLS SURGICAL MEDICAL CENTER, INC : BEVERLY HILLS, CA

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General NPI Number Information
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    NPI Number           |    1922323849
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    Entity Type          |    Organization 
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    Legal Business Name  |    ROXBURY BEVERLY HILLS SURGICAL MEDICAL CENTER, INC 
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Dates
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    Enumeration Date     |    04/03/2010
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    Last Update Date     |    04/03/2010
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Provider Practice Location Address
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    Address Line         |    435 N ROXBURY DR SUITE 405
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    City                 |    BEVERLY HILLS
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    State                |    CA
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    Zip                  |    90210-5027
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    Country              |    US
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    Telephone            |    310-275-2472
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    Fax                  |    310-247-9732
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Provider Business Mailing Address
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    Address Line         |    435 N ROXBURY DR SUITE 405
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    City                 |    BEVERLY HILLS
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    State                |    CA
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    Zip                  |    90210-5027
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    Country              |    US
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    Telephone            |    310-275-2472
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    Fax                  |    310-247-9732
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Authorized Official
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    Title or Position    |    MEDICAL DIRECTOR
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    Name                 |     ALEXANDER  SOROKURS 
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    Credential           |    M.D.
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    Telephone            |    310-275-2472
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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       |    A54193
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    License Number State |    CA
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