Beverly Community Clinic | |
2252 Beverly Blvd Ste 103 Los Angeles CA 90057-2246 | |
(213) 674-7424 | |
Not Available |
Full Name | Beverly Community Clinic |
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Speciality | Clinic/Center |
Location | 2252 Beverly Blvd Ste 103, Los Angeles, California |
Authorized Official Name and Position | John Burns (CHIEF MEDICAL OFFICER) |
Authorized Official Contact | 2136747424 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Beverly Community Clinic 2252 Beverly Blvd Ste 103 Los Angeles CA 90057-2246 Ph: (213) 674-7424 | Beverly Community Clinic 2252 Beverly Blvd Ste 103 Los Angeles CA 90057-2246 Ph: (213) 674-7424 |
NPI Number | 1144791500 |
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Provider Enumeration Date | 12/11/2018 |
Last Update Date | 03/19/2024 |
Medicare PECOS PAC ID | 7810301926 |
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Medicare Enrollment ID | O20210202000693 |
Identifier | Type | State | Issuer |
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1144791500 | NPI | - | NPPES |
Provider Name | Jacob N Flores |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1164469201 PECOS PAC ID: 7719960434 Enrollment ID: I20040611001036 |
Provider Name | John S Burns |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407921737 PECOS PAC ID: 0648336958 Enrollment ID: I20090311000251 |
Provider Name | Susanne Kathleen Cohen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982087128 PECOS PAC ID: 9537516919 Enrollment ID: I20231128001695 |
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