Provider Demographics
NPI:1215307822
Name:BRIGHTON SURGICAL ENDOSCOPY LLC
Entity type:Organization
Organization Name:BRIGHTON SURGICAL ENDOSCOPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:KARYOTAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-278-3033
Mailing Address - Street 1:9675 BRIGHTON WAY
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5100
Mailing Address - Country:US
Mailing Address - Phone:310-278-3033
Mailing Address - Fax:
Practice Address - Street 1:9675 BRIGHTON WAY
Practice Address - Street 2:SUITE ONE
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5100
Practice Address - Country:US
Practice Address - Phone:310-278-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical