Healthcare Provider Details
I. General information
NPI: 1699439232
Provider Name (Legal Business Name): HEARTBEAT MEDICAL GROUP OF CALIFORNIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2021
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
818 W 7TH ST STE 930
LOS ANGELES CA
90017-3476
US
IV. Provider business mailing address
156 W 56TH ST STE 1000
NEW YORK NY
10019-3936
US
V. Phone/Fax
- Phone: 646-586-9908
- Fax: 844-875-9993
- Phone: 646-586-9908
- Fax: 844-875-6663
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
D
WESSLER
Title or Position: CEO/OWNER
Credential: MD
Phone: 646-586-9908