NPIMap

Organization Active NPI

Beverly Hills Dermatology Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
National Provider Identifier
1669886388
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BEVERLY HILLS DERMATOLOGY SURGERY CENTER
Practice address
433 N Camden Dr Ste 805
Beverly Hills, CA 90210-4412
Phone
(310) 550-7661
Fax
(310) 550-1920
NPI assigned
Jun 20, 2014
Last updated
Jun 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Mrs. Letantia Bussell, M.D.NPI 1437183068
Title
Medical Director
Phone
(310) 550-7661

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 CA Primary

Addresses

Primary practice location

433 N Camden Dr Ste 805
Beverly Hills, CA 90210-4412

Mailing address

433 N Camden Dr Ste 805
Beverly Hills, CA 90210-4412
Phone (310) 550-7661

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1669886388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 N CAMDEN DR STE 805",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104412",
            "telephone_number": "310-550-7661",
            "fax_number": "310-550-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 N CAMDEN DR STE 805",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104412",
            "telephone_number": "310-550-7661",
            "fax_number": "310-550-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY HILLS DERMATOLOGY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "BUSSELL",
        "authorized_official_first_name": "LETANTIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-550-7661",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 20, 2014; 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.