Provider Demographics
NPI:1962154419
Name:BEVERLY HILLS HEALTH AND AESTHETICS CENTER, INC
Entity type:Organization
Organization Name:BEVERLY HILLS HEALTH AND AESTHETICS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-277-9905
Mailing Address - Street 1:1125 S. BEVERLY DRIVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1149
Mailing Address - Country:US
Mailing Address - Phone:310-277-9905
Mailing Address - Fax:310-277-9922
Practice Address - Street 1:1125 S. BEVERLY DRIVE
Practice Address - Street 2:SUITE 111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1149
Practice Address - Country:US
Practice Address - Phone:310-277-9905
Practice Address - Fax:310-277-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty