MODERN INSTITUE OF SURGERY INC NPI 1568899177

NPI Information

NPI: 1568899177
Provider Name: MODERN INSTITUE OF SURGERY, INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D2078274

Address:
9090 BURTON WAY
BEVERLY HILLS, CA
ZIP 90211
Phone: (310) 278-0077
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MODERN INSTITUE OF SURGERY, INC is an ambulatory surgical clinic center in Beverly Hills, CA. MODERN INSTITUE OF SURGERY, INC NPI is 1568899177. The provider is registered as an organization entity type.

The provider's business location address is:

9090 BURTON WAY
BEVERLY HILLS, CA
ZIP 90211-661
Phone: (310) 278-0077

The provider's authorized official is Ivailo Dimov .
The authorized official title is Medical Director and has the following contact phone number (310) 278-0077.

The CLIA number assigned to this NPI record is 05D2078274 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2013 and was last updated on 12/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	C3580319	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0000000000	OTHER	CALIFORNIA	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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