| |
8405 Beverly Blvd Los Angeles CA 90048-3401 | |
(323) 653-8622 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 8405 Beverly Blvd, Los Angeles, California |
Authorized Official Name and Position | Muriel Nouwezem (CEO) |
Authorized Official Contact | 3233371707 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
8405 Beverly Blvd Los Angeles CA 90048-3401 Ph: () - | 8405 Beverly Blvd Los Angeles CA 90048-3401 Ph: (323) 653-8622 |
NPI Number | 1194893248 |
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Provider Enumeration Date | 11/30/2006 |
Last Update Date | 08/30/2024 |
Medicare PECOS PAC ID | 5395886311 |
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Medicare Enrollment ID | O20100112000638 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194893248 | NPI | - | NPPES |
FHC70701F | Medicaid | CA | |
CMM70945F | Medicaid | CA | |
EAP00005F | Medicaid | CA | |
BCP70654F | Medicaid | CA | |
BCP70701F | Medicaid | CA | |
HAP70654F | Medicaid | CA | |
FHC70654F | Medicaid | CA | |
HAP70701F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (California) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Tinh C Vuong |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750569885 PECOS PAC ID: 5395874549 Enrollment ID: I20100526000346 |
Provider Name | Aaron Savar |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1124182662 PECOS PAC ID: 0345306007 Enrollment ID: I20101228000256 |
Provider Name | Sarah M Domb |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1801168208 PECOS PAC ID: 3375771595 Enrollment ID: I20140116000150 |
Provider Name | Oswald Chan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780676882 PECOS PAC ID: 8729201736 Enrollment ID: I20140520002027 |
Provider Name | Farshid Fararooy |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922045939 PECOS PAC ID: 4082887187 Enrollment ID: I20140717000145 |
Provider Name | Jennifer J Lee |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1669731295 PECOS PAC ID: 5890916266 Enrollment ID: I20160922001539 |
Provider Name | Veronica Mae Garcia |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1356693675 PECOS PAC ID: 8426316340 Enrollment ID: I20171226002013 |
Provider Name | Jennifer M Nguyen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609395649 PECOS PAC ID: 6800154667 Enrollment ID: I20171227002553 |
Provider Name | Ghassan Hani Nicola Khoury |
---|---|
Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1003153214 PECOS PAC ID: 3274831649 Enrollment ID: I20180507002064 |
Provider Name | Christine S Kim |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346733946 PECOS PAC ID: 5294103081 Enrollment ID: I20221129002029 |
Provider Name | Rita Marie Rossi Foulkes |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427011709 PECOS PAC ID: 8426059825 Enrollment ID: I20230323001073 |
Provider Name | Ryan Francis Gabriel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568028124 PECOS PAC ID: 9931433463 Enrollment ID: I20230629001795 |
Provider Name | Gina Nan Mo |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1609321892 PECOS PAC ID: 5395105464 Enrollment ID: I20230720002744 |
Provider Name | Stephanie Chang |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346809001 PECOS PAC ID: 7214398486 Enrollment ID: I20230803003094 |
Provider Name | Manvir Singh Dhillon |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083293252 PECOS PAC ID: 9335597525 Enrollment ID: I20231129000399 |
Provider Name | Helena Marie Garcia |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1396227898 PECOS PAC ID: 7315380896 Enrollment ID: I20240212003480 |
Provider Name | Yanet Carina Gonzalez |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1265997100 PECOS PAC ID: 2062856354 Enrollment ID: I20240214002489 |
Provider Name | Jessica Elaine Keane |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1952950230 PECOS PAC ID: 7315381654 Enrollment ID: I20240214004225 |
Provider Name | Jennifer Mary Matthes |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1801313515 PECOS PAC ID: 8325482300 Enrollment ID: I20240217000528 |
Provider Name | Kendall Marie Keefe |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417413568 PECOS PAC ID: 6305280074 Enrollment ID: I20240221001848 |
Provider Name | Salmaan Zaki Kamal |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023505534 PECOS PAC ID: 0547679631 Enrollment ID: I20240222003626 |
Provider Name | Daisy Luna-torres |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1508280637 PECOS PAC ID: 7911342688 Enrollment ID: I20240304003357 |
Provider Name | Brigid Quinn Donahue |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1689949844 PECOS PAC ID: 2062857659 Enrollment ID: I20240305003809 |
Provider Name | Hugo Alberto Sanchez |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1871054148 PECOS PAC ID: 6800233214 Enrollment ID: I20240321000554 |
Provider Name | Jessica Cristina Portillo |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639581630 PECOS PAC ID: 2860619020 Enrollment ID: I20240617000991 |
Provider Name | Carlos J Silva Lynch |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477132744 PECOS PAC ID: 6204370877 Enrollment ID: I20240708000889 |
Provider Name | Liza Rochelle Raffi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396324596 PECOS PAC ID: 6204371826 Enrollment ID: I20240708003347 |
Provider Name | Alicia Diaz |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1609201086 PECOS PAC ID: 8527506336 Enrollment ID: I20240812002134 |
Provider Name | Damian Charles Braun Kerr |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1215629696 PECOS PAC ID: 7416488184 Enrollment ID: I20241004002463 |
Provider Name | Rachel Barbour Ukwu |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1023571239 PECOS PAC ID: 0042545501 Enrollment ID: I20241007001545 |
Provider Name | Anna Skor Noble |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1558591800 PECOS PAC ID: 3678886785 Enrollment ID: I20241011002351 |
Provider Name | Nicole Snyder |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1306550751 PECOS PAC ID: 2466984133 Enrollment ID: I20241018002372 |
Provider Name | Nicole Alexandra Zubia |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1215628425 PECOS PAC ID: 0941732424 Enrollment ID: I20241022003701 |
Provider Name | Neil R Modi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730718008 PECOS PAC ID: 7416481726 Enrollment ID: I20241108003043 |
Provider Name | Jaime Michelle La Charite |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437680378 PECOS PAC ID: 1456637297 Enrollment ID: I20241113000843 |
Provider Name | Elizabeth Lorena Suarez |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1376159038 PECOS PAC ID: 0143754473 Enrollment ID: I20241113002235 |
Provider Name | Parker George Albert Jobin |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275100885 PECOS PAC ID: 9133653884 Enrollment ID: I20241118001184 |
Provider Name | Allison Katharine Dietze |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1164157285 PECOS PAC ID: 7911433198 Enrollment ID: I20241211002065 |
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 | |