Healthcare Provider Details

I. General information

NPI: 1760339733
Provider Name (Legal Business Name): BEVERLY GALE HAMMOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 S ELM DR APT 3
BEVERLY HILLS CA
90212-3322
US

IV. Provider business mailing address

145 S ELM DR APT 3
BEVERLY HILLS CA
90212-3322
US

V. Phone/Fax

Practice location:
  • Phone: 323-979-2265
  • Fax:
Mailing address:
  • Phone: 323-979-2265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number49761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: