Organization Name: | BEVERLY HILLS MEDICAL CORPORATION |
NPI Number: | 1740213222 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALI HADADZ (PRESIDENT) |
Mailing Address: | 9808 Venice Blvd Suite 503 Culver City |
State: | CA US |
Postal Code: | 902326804 |
Phone Number: | 3102045510 |
Fax Number: | 3102045518 |
NPI Enumeration Date: | 07/08/2006 |
NPI Last Update Date: | 09/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |