| Beverly Internal Medicine Medical Group Inc. | |
|
2614 W Beverly Blvd Montebello CA 90640-2310 | |
| (323) 728-0653 | |
| Not Available |
| Full Name | Beverly Internal Medicine Medical Group Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2614 W Beverly Blvd, Montebello, California |
| Authorized Official Name and Position | Soumitra Sarkar (PRESIDENT) |
| Authorized Official Contact | 3237280653 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Internal Medicine Medical Group Inc. 2614 W Beverly Blvd Montebello CA 90640-2310 Ph: (323) 728-0653 | Beverly Internal Medicine Medical Group Inc. 2614 W Beverly Blvd Montebello CA 90640-2310 Ph: (323) 728-0653 |
| NPI Number | 1568642197 |
|---|---|
| Provider Enumeration Date | 11/12/2007 |
| Last Update Date | 02/21/2014 |
| Medicare PECOS PAC ID | 9931137510 |
|---|---|
| Medicare Enrollment ID | O20050803001259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568642197 | NPI | - | NPPES |
| 110208996 | Other | CA | RAILROAD MEDICARE |
| 00A534990 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A53499 (California) | Primary |
| Provider Name | Soumitra Sarkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578573010 PECOS PAC ID: 6103978432 Enrollment ID: I20090717000457 |
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