1427075142 NPI number — SPALDING SURGICAL CENTER OF BEVERLY HILLS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427075142 NPI number — SPALDING SURGICAL CENTER OF BEVERLY HILLS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPALDING SURGICAL CENTER OF BEVERLY HILLS, LLC
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:
1427075142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1809 E. DYER ROAD
Provider Second Line Business Mailing Address:
SUITE #311
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-863-0022
Provider Business Mailing Address Fax Number:
949-606-9574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 S. SPALDING DRIVE
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90212-1800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-385-7755
Provider Business Practice Location Address Fax Number:
310-385-0874
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHERMAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
310-385-7755

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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