1194999540 NPI number — BEVERLY HILLS HAND & REHAB CTR

Table of content: (NPI 1194999540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194999540 NPI number — BEVERLY HILLS HAND & REHAB CTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEVERLY HILLS HAND & REHAB CTR
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194999540
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1586
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93102-1586
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-201-8478
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 SOUTH BEVERLY DRIVE 611
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-201-2016
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LUCKETT
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
310-201-2016

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)