MEDICARE: ELEN BEREMESH NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95039879	CA

General Provider Information

NPI Number	:	1831022607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELEN BEREMESH NP

Provider Business Mailing Address
First Line	:	1500 S CENTRAL AVE STE 323
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-3858
Country	:	US
Telephone Number	:	747-200-6948
Fax Number	:	747-800-8005

Provider Business Practice Location Address
First Line	:	1500 S CENTRAL AVE STE 323
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-3858
Country	:	US
Telephone Number	:	747-200-6948
Fax Number	:	747-800-8005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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