Provider Demographics
NPI:1528300456
Name:BEVERLY HILLS PEDIATRIC SURGERY
Entity type:Organization
Organization Name:BEVERLY HILLS PEDIATRIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:CHI-LONG
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-598-7738
Mailing Address - Street 1:8920 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 326
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2007
Mailing Address - Country:US
Mailing Address - Phone:310-598-7738
Mailing Address - Fax:310-657-0096
Practice Address - Street 1:8920 WILSHIRE BLVD
Practice Address - Street 2:SUITE 326
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2007
Practice Address - Country:US
Practice Address - Phone:310-598-7738
Practice Address - Fax:310-657-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76785174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty