Basic Information
| Provider Information | |||||||||
| NPI: | 1295481224 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TMS & DEPRESSION CENTER OF BEVERLY HILLS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9777 WILSHIRE BLVD STE 807 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902121908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102764003 | ||||||||
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| Address1: | 9777 WILSHIRE BLVD STE 807 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902121908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109270827 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2022 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | BOWMAN | ||||||||
| AuthorizedOfficialFirstName: | PHILLIP | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3102764003 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.