Organization Active NPI

Beverly Hills Medical Center

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
National Provider Identifier
1477088540
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
19917 Issued in CA
Legal business name
BEVERLY HILLS MEDICAL CENTER
Practice address
414 N Camden Dr
Suite 101
Beverly Hills, CA 90210-4532
Phone
(310) 888-8818
NPI assigned
Apr 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Authorized official

Name
Brian H Novack, M.D.NPI 1235262999
Title
President
Phone
(310) 888-8818

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 19917 CA Primary

Addresses

Primary practice location

414 N Camden Dr
Suite 101
Beverly Hills, CA 90210-4532

Mailing address

414 N Camden Dr
Suite 101
Beverly Hills, CA 90210-4532
Phone (310) 888-8818

Other identifiers 1

IdentifierTypeStateIssuer
19917OtherCAAAAHC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1072896Beverly Hills Medical Center414 N Camden Dr Ste1010, Beverly Hills, CA 90210Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory

Locations

414 N Camden Dr
Ste 101
Beverly Hills, CA 90210
Phone (310) 888-8818

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": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1477088540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N CAMDEN DR",
            "address_2": "SUITE 101",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104532",
            "telephone_number": "310-888-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 N CAMDEN DR",
            "address_2": "SUITE 101",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104532",
            "telephone_number": "310-888-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY HILLS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "NOVACK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-888-8818",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "19917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAHC",
            "identifier": "19917",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.