Organization Active NPI

Surgeon Services Professional Corporation

  • Otolaryngology/Facial Plastic Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1861755654
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
A78700 Issued in CA
Legal business name
SURGEON SERVICES PROFESSIONAL CORPORATION
Practice address
9400 Brighton Way
Penthouse
Beverly Hills, CA 90210-4714
Phone
(310) 859-9816
Fax
(310) 859-9815
NPI assigned
Jun 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Jason Diamond, MD
Title
Sole Owner
Phone
(310) 859-9816

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X A78700 CA
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X A78700 CA
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0905X A78700 CA Primary

Addresses

Primary practice location

9400 Brighton Way
Penthouse
Beverly Hills, CA 90210-4714

Mailing address

9400 Brighton Way
Penthouse Suite
Beverly Hills, CA 90210-4714
Phone (310) 859-9816

National Provider Directory

National Provider Directory

Locations

9400 Brighton Way
Ph
Beverly Hills, CA 90210
Phone (310) 276-2033

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": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1861755654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 BRIGHTON WAY",
            "address_2": "PENTHOUSE SUITE",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104714",
            "telephone_number": "310-859-9816",
            "fax_number": "310-859-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 BRIGHTON WAY",
            "address_2": "PENTHOUSE",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104714",
            "telephone_number": "310-859-9816",
            "fax_number": "310-859-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGEON SERVICES PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "310-859-9816",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A78700",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A78700",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "A78700",
            "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 18, 2012; 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.