Modern Institue of Surgery, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

C3580319 Issued in CA

Legal business name

MODERN INSTITUE OF SURGERY, INC

Practice address

9090 Burton Way
Beverly Hills, CA 90211-1661

Phone

(310) 278-0077

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ivailo Dimov, M.D.

Title

Medical Director

Phone

(310) 278-0077

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1568899177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9090 BURTON WAY",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111661",
            "telephone_number": "310-278-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9090 BURTON WAY",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111661",
            "telephone_number": "310-278-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN INSTITUE OF SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "DIMOV",
        "authorized_official_first_name": "IVAILO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-278-0077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "C3580319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0000000000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mobile Cardiac Imaging
• Mobin Medical Corporation
• Fardad Mobin, M.D.
• Farivar Mobin, D.C.
• Robert Mocharla, M.D.
• Modern Institute of Plastic Surgery & Antiaging, Inc.
• Modern Intitute of Plastic Surgery & Anti-Aging
• Modern Surgery Centers LLC
• Michael Modica, M.D.
• Brent R.W. Moelleken, M.D.

• Ambulatory Surgical Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.