# 436 BEVERLY HILLS, LLC

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

## Provider details

- **NPI number:** 1972694487
- **Authorized official:** LISA BENKE CASSILETH M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (310) 278-8200

## Contact information

- **Practice address:** 436 N BEDFORD DR, SUITE 102, BEVERLY HILLS, CA 90210-4310
- **Practice address phone:** (310) 278-8200
- **Mailing address:** 436 N BEDFORD DR, SUITE 102, BEVERLY HILLS, CA 90210-4310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 08/22/2020