Provider Demographics
NPI:1063179570
Name:DOHENY SURGERY CENTER, LLC
Entity type:Organization
Organization Name:DOHENY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHROOZAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-205-0111
Mailing Address - Street 1:9090 BURTON WAY
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1661
Mailing Address - Country:US
Mailing Address - Phone:310-205-0111
Mailing Address - Fax:310-299-3939
Practice Address - Street 1:9090 BURTON WAY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1661
Practice Address - Country:US
Practice Address - Phone:310-205-0111
Practice Address - Fax:310-299-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical