# LASKY DRIVE SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649045493
- **Authorized official:** DR. SHAHRAD RADY RAHBAN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (310) 550-9858

## Contact information

- **Practice address:** 152 S LASKY DR STE 102, BEVERLY HILLS, CA 90212-1715
- **Practice address phone:** (310) 550-9858
- **Mailing address:** 152 S LASKY DR STE 102, BEVERLY HILLS, CA 90212-1715
- **Mailing address phone:** (310) 550-9858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208200000X | Plastic Surgery Physician | — | NULL | — |
| 208200000X | Plastic Surgery Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/21/2023
- **Last updated:** 03/18/2024