Organization
436 BEVERLY HILLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BENKE CASSILETH M.D. (MEDICAL DIRECTOR)
(310) 278-8200
Entity
Organization
Contact information
Practice address
436 N BEDFORD DR, SUITE 102, BEVERLY HILLS, CA 90210-4310
(310) 278-8200
Mailing address
436 N BEDFORD DR, SUITE 102, BEVERLY HILLS, CA 90210-4310
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2006
Last updated
08/22/2020
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