Healthcare Provider Details

I. General information

NPI: 1043168933
Provider Name (Legal Business Name): BE WELL MEDICAL GROUP A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8671 WILSHIRE BLVD STE 701
BEVERLY HILLS CA
90211-2913
US

IV. Provider business mailing address

8671 WILSHIRE BLVD STE 701
BEVERLY HILLS CA
90211-2913
US

V. Phone/Fax

Practice location:
  • Phone: 310-810-3666
  • Fax: 310-810-1885
Mailing address:
  • Phone: 310-810-3666
  • Fax: 310-810-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ISAAC BERLIN
Title or Position: CHIEF OPERATING OFFICER
Credential: MSN, FNP-C
Phone: 310-810-3666