1235500380 NPI number — BEVERLY HILLS SURGICAL INSTITUTE INC

Table of content: (NPI 1235500380)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235500380 NPI number — BEVERLY HILLS SURGICAL INSTITUTE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEVERLY HILLS SURGICAL INSTITUTE INC
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:
6
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:
1235500380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
436 N ROXBURY DR STE 117
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90210-5016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-385-9623
Provider Business Mailing Address Fax Number:
310-913-8450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
438 E KATELLA AVE
Provider Second Line Business Practice Location Address:
D
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92867-4839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-202-0325
Provider Business Practice Location Address Fax Number:
310-385-8450
Provider Enumeration Date:
10/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KAPOOR
Authorized Official First Name:
VISHAL
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
310-913-1735

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  A82791 , 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)





Copyright © 2007-2025 www.npivalidator.com