MEDICARE: BEVERLY HILLS INTEGRATED SURGICAL, INC

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	:	1215234349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY HILLS INTEGRATED SURGICAL, INC

Provider Business Mailing Address
First Line	:	269 S. BEVERLY DRIVE
Second Line	:	SUITE 1500
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3851
Country	:	US
Telephone Number	:	310-275-5400
Fax Number	:	310-275-5407

Provider Business Practice Location Address
First Line	:	9231 W. OLYMPIC BLVD.
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4658
Country	:	US
Telephone Number	:	310-275-5400
Fax Number	:	310-275-5407

Authorized Official
Title or Position	:	CEO
Name	:	ADAM KIRSHNER
Credential	:
Telephone Number	:	310-275-5400

Provider Enumeration Date	:	02/25/2011
Last Update Date	:	06/10/2022

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