# SURGEON SERVICES PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1861755654
- **Authorized official:** JASON DIAMOND MD (SOLE OWNER)
- **Authorized official phone:** (310) 859-9816

## Contact information

- **Practice address:** 9400 BRIGHTON WAY, PENTHOUSE, BEVERLY HILLS, CA 90210-4714
- **Practice address phone:** (310) 859-9816
- **Practice address fax:** (310) 859-9815
- **Mailing address:** 9400 BRIGHTON WAY, PENTHOUSE SUITE, BEVERLY HILLS, CA 90210-4714
- **Mailing address phone:** (310) 859-9816
- **Mailing address fax:** (310) 859-9815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | A78700 | CA | — |
| 207X00000X | Orthopaedic Surgery Physician | A78700 | CA | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | A78700 | CA | Yes |

## Other

- **Enumeration date:** 06/18/2012
- **Last updated:** 06/18/2012