| Bea Medical Group, Inc. | |
|
10070 Pasadena Ave Ste 2 Cupertino CA 95014-5942 | |
| (408) 746-0300 | |
| Not Available |
| Full Name | Bea Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 10070 Pasadena Ave, Cupertino, California |
| Authorized Official Name and Position | Laura Stevens (CEO, CFO, PRESIDENT, & FOUNDER) |
| Authorized Official Contact | 4087460300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bea Medical Group, Inc. 10070 Pasadena Ave Ste 2 Cupertino CA 95014-5942 Ph: (408) 746-0300 | Bea Medical Group, Inc. 10070 Pasadena Ave Ste 2 Cupertino CA 95014-5942 Ph: (408) 746-0300 |
| NPI Number | 1679533780 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 04/26/2022 |
| Medicare PECOS PAC ID | 9537160528 |
|---|---|
| Medicare Enrollment ID | O20070117000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679533780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | FNP 34120 (California) | Primary |
| 261QP2300X | Clinic/center - Primary Care | CLM 311477 (California) | Secondary |
| Provider Name | Laura Stevens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366553372 PECOS PAC ID: 5698877488 Enrollment ID: I20070226000337 |
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