MEDICARE: PACIFIC COAST AMBULATORY SURGERY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1033041843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC COAST AMBULATORY SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	435 N BEDFORD DR STE 111
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4331
Country	:	US
Telephone Number	:	310-974-8767
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 N BEDFORD DR STE 111
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4331
Country	:	US
Telephone Number	:	310-974-8767
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ALI GOLSHAN
Credential	:	MD
Telephone Number	:	310-974-8767

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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