Beverly Medical Group | |
2105 Beverly Blvd Ste 233b Los Angeles CA 90057-2216 | |
(213) 674-7859 | |
(213) 277-1055 |
Full Name | Beverly Medical Group |
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Speciality | Clinic/Center |
Location | 2105 Beverly Blvd Ste 233b, Los Angeles, California |
Authorized Official Name and Position | Nicholas N Dzebolo (CEO) |
Authorized Official Contact | 1327710302 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Beverly Medical Group 2105 Beverly Blvd Ste 233b Los Angeles CA 90057-2216 Ph: (213) 674-7859 | Beverly Medical Group 2105 Beverly Blvd Ste 233b Los Angeles CA 90057-2216 Ph: (213) 674-7859 |
NPI Number | 1326622143 |
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Provider Enumeration Date | 05/07/2021 |
Last Update Date | 06/23/2021 |
Medicare PECOS PAC ID | 4385044858 |
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Medicare Enrollment ID | O20210621002761 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326622143 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Nicholas N Dzebolo |
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Provider Type | Practitioner - Interventional Radiology |
Provider Identifiers | NPI Number: 1932239837 PECOS PAC ID: 3678464013 Enrollment ID: I20040323002048 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |