Healthcare Provider Details

I. General information

NPI: 1114867710
Provider Name (Legal Business Name): BEVERLYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W BEVERLY BLVD
MONTEBELLO CA
90640-3622
US

IV. Provider business mailing address

433 N 4TH ST STE 205A
MONTEBELLO CA
90640-4311
US

V. Phone/Fax

Practice location:
  • Phone: 323-920-0505
  • Fax: 888-871-4071
Mailing address:
  • Phone: 323-920-0505
  • Fax: 888-871-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ANGEL HSIAO
Title or Position: CEO
Credential:
Phone: 323-920-0505