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General NPI Number Information
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NPI Number | 1942767801
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Entity Type | Organization
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Legal Business Name | PLAZA HEALTH SERVICES INC.
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 11111 SANTA MONICA BLVD STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90025-3333
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Country | US
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Telephone | 310-358-5568
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Fax | 310-933-0559
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Provider Business Mailing Address
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Address Line | 11111 SANTA MONICA BLVD STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90025-3333
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Country | US
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Telephone | 310-358-5568
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Fax | 310-933-0559
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Authorized Official
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Title or Position | OWNER
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Name | DR. PEYTON BEROOKIM
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Credential | MD
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Telephone | 310-358-5568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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