Organization
SURGEON SERVICES PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DIAMOND MD (SOLE OWNER)
(310) 859-9816
Entity
Organization
Contact information
Practice address
9400 BRIGHTON WAY, PENTHOUSE, BEVERLY HILLS, CA 90210-4714
(310) 859-9816
(310) 859-9815
Mailing address
9400 BRIGHTON WAY, PENTHOUSE SUITE, BEVERLY HILLS, CA 90210-4714
(310) 859-9816
(310) 859-9815
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
A78700
CA
207X00000X
Orthopaedic Surgery Physician
A78700
CA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
A78700
CA
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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