Healthcare Provider Details

I. General information

NPI: 1760282990
Provider Name (Legal Business Name): BEHUMAN MEDICAL GROUP CALIFORNIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 SAMARITAN CT STE G
SAN JOSE CA
95124-4002
US

IV. Provider business mailing address

16442 NE 31ST AVE
NORTH MIAMI BEACH FL
33160-4135
US

V. Phone/Fax

Practice location:
  • Phone: 305-523-9787
  • Fax: 754-310-1422
Mailing address:
  • Phone: 305-523-9787
  • Fax: 754-310-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: INNA YASKIN
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 305-523-9787