| Beverly Hills Medical Corporation | |
|
9808 Venice Blvd Suite 503 Culver City CA 90232-6804 | |
| (310) 204-5510 | |
| (310) 204-5518 |
| Full Name | Beverly Hills Medical Corporation |
|---|---|
| Speciality | General Practice |
| Location | 9808 Venice Blvd, Culver City, California |
| Authorized Official Name and Position | Ali Hadadz (PRESIDENT) |
| Authorized Official Contact | 3102745510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Hills Medical Corporation 9808 Venice Blvd Suite 503 Culver City CA 90232-6804 Ph: (310) 204-5510 | Beverly Hills Medical Corporation 9808 Venice Blvd Suite 503 Culver City CA 90232-6804 Ph: (310) 204-5510 |
| NPI Number | 1740213222 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 09/19/2014 |
| Medicare PECOS PAC ID | 5294889515 |
|---|---|
| Medicare Enrollment ID | O20090820000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740213222 | NPI | - | NPPES |
| 010066259 | Other | CA | MEDICARE RAILROAD |
| 00A698160 | Medicaid | CA | |
| ZZZ05665Z | Other | CA | BLUE SHIELD CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ali Hadadz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1316970866 PECOS PAC ID: 6204980527 Enrollment ID: I20090820000238 |
| Provider Name | Jaana Salonsaari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568863348 PECOS PAC ID: 1052638376 Enrollment ID: I20150326000452 |
| Provider Name | Pedro Morante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689038507 PECOS PAC ID: 4385937861 Enrollment ID: I20161205002451 |
| Provider Name | Wenting Wei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619575198 PECOS PAC ID: 9436593076 Enrollment ID: I20240222000370 |
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