MEDICARE: BEVERLY HILLS ORTHOPEDIC CENTER, 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	207X00000X	Orthopaedic Surgery Physician	A84242	CA

General Provider Information

NPI Number	:	1629299318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY HILLS ORTHOPEDIC CENTER, INC.

Provider Business Mailing Address
First Line	:	8306 WILSHIRE BLVD
Second Line	:	SUITE 3004
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2304
Country	:	US
Telephone Number	:	310-854-1123
Fax Number	:

Provider Business Practice Location Address
First Line	:	292 S LA CIENEGA BLVD
Second Line	:	SUITE 100
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3330
Country	:	US
Telephone Number	:	310-854-1123
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HAMID MIRALIAKBAR
Credential	:	M.D.
Telephone Number	:	310-854-1123

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	08/22/2020

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