Healthcare Provider Details

I. General information

NPI: 1184718587
Provider Name (Legal Business Name): BEACHCARDIOLOGYMED.GROUP INC.,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15581 BROOKHURST ST
WESTMINSTER CA
92683-7554
US

IV. Provider business mailing address

15581 BROOKHURST ST
WESTMINSTER CA
92683-7554
US

V. Phone/Fax

Practice location:
  • Phone: 714-839-2122
  • Fax:
Mailing address:
  • Phone: 714-839-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberA26101
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA26101
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TSS RAJAN
Title or Position: DIRECTOR,PRESIDENT
Credential: M.D,
Phone: 714-839-2122