Healthcare Provider Details

I. General information

NPI: 1164336632
Provider Name (Legal Business Name): BEVERLYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15141 WHITTIER BLVD STE 340
WHITTIER CA
90603-2146
US

IV. Provider business mailing address

433 N 4TH ST STE 205A
MONTEBELLO CA
90640-4306
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 TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANGEL HSIAO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 323-920-0505