Organization Active NPI

Omni Ambulatory Surgery Center Inc.

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
National Provider Identifier
1255063004
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
OMNI AMBULATORY SURGERY CENTER INC.
Practice address
436 N Bedford Dr Ste 205
Beverly Hills, CA 90210-4312
Phone
(310) 247-8978
Fax
(310) 425-3214
NPI assigned
Jun 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nicholas R Nikolov, MDNPI 1831242023
Title
Medical Director
Phone
(310) 247-1932

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

436 N Bedford Dr Ste 205
Beverly Hills, CA 90210-4312

Mailing address

436 N Bedford Dr Ste 205
Beverly Hills, CA 90210-4312
Phone (310) 247-8978

Other names 1

  • Omni Ambulatory Surgery Center, Inc Doing business as

National Provider Directory

National Provider Directory

Locations

436 N Bedford Dr
Ste 205
Beverly Hills, CA 90210
Phone (310) 247-8978

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1255063004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 205",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104312",
            "telephone_number": "310-247-8978",
            "fax_number": "310-425-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 205",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104312",
            "telephone_number": "310-247-8978",
            "fax_number": "310-425-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI AMBULATORY SURGERY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "NIKOLOV",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-247-1932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Ambulatory Surgery Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omni Ambulatory Surgery Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.