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General NPI Number Information
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NPI Number | 1952516395
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Entity Type | Organization
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Legal Business Name | ROBERTSON SURGICAL CENTER LLC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 150 N ROBERTSON BLVD # 110
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2142
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Country | US
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Telephone | 310-659-2400
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Fax | 310-659-2452
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Provider Business Mailing Address
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Address Line | 150 N ROBERTSON BLVD # 110
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2142
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Country | US
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Telephone | 310-659-2400
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Fax | 310-659-2452
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BABAK LARIAN
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Credential | M.D.
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Telephone | 310-272-7780
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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 | 051698
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License Number State | CA
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