| Prestige Gi | |
|
250 N Robertson Blvd Ste 106 Beverly Hills CA 90211-1767 | |
| (323) 800-1000 | |
| (877) 239-0994 |
| Full Name | Prestige Gi |
|---|---|
| Speciality | Internal Medicine |
| Location | 250 N Robertson Blvd Ste 106, Beverly Hills, California |
| Authorized Official Name and Position | Seper Dezfoli (PHYSICIAN) |
| Authorized Official Contact | 3238001000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Gi 369 S Doheny Dr Ste 1121 Beverly Hills CA 90211-3508 Ph: (323) 800-1000 | Prestige Gi 250 N Robertson Blvd Ste 106 Beverly Hills CA 90211-1767 Ph: (323) 800-1000 |
| NPI Number | 1649756164 |
|---|---|
| Provider Enumeration Date | 07/18/2018 |
| Last Update Date | 03/24/2021 |
| Medicare PECOS PAC ID | 4284984170 |
|---|---|
| Medicare Enrollment ID | O20180914001114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649756164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Seper Dezfoli |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104159383 PECOS PAC ID: 1658545264 Enrollment ID: I20111116000856 |
| Provider Name | Jin Guo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538375217 PECOS PAC ID: 1254587553 Enrollment ID: I20120801000652 |
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