Provider Demographics
NPI:1144552647
Name:MOY-FINCHER-CHIPPS SURGERY CENTER, INC.
Entity type:Organization
Organization Name:MOY-FINCHER-CHIPPS SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-274-5372
Mailing Address - Street 1:421 N. RODEO DR.
Mailing Address - Street 2:2ND FLOOR TERRACE LEVEL NORTH
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4500
Mailing Address - Country:US
Mailing Address - Phone:310-274-5372
Mailing Address - Fax:310-274-5380
Practice Address - Street 1:421 N RODEO DR
Practice Address - Street 2:2ND FLOOR TERRACE LEVEL NORTH
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4500
Practice Address - Country:US
Practice Address - Phone:310-274-5372
Practice Address - Fax:310-274-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051277ZMedicare PIN