# BEVERLY HILLS LASKY CLINIC SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BEVERLY HILLS LASKY SURGICENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124361282
- **Authorized official:** MR. THOMAS C CLOUD MPH (MEDICAL BILLING MANAGER)
- **Authorized official phone:** (323) 301-2178

## Contact information

- **Practice address:** 152 S LASKY DR, SUITE 106, BEVERLY HILLS, CA 90212-1720
- **Practice address phone:** (323) 301-2178
- **Practice address fax:** (866) 844-4712
- **Mailing address:** 160 S LASKY DR, BEVERLY HILLS, CA 90212-1704
- **Mailing address phone:** (323) 301-2178
- **Mailing address fax:** (866) 844-4712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | AAAASF 1371 | CA | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | JACHO 538887 | CA | — |

## Other

- **Enumeration date:** 03/27/2013
- **Last updated:** 07/30/2013