NPI Code Detail JSON Logo

1114867710 NPI number — BEVERLYCARE

NPI Number: 1114867710
Health Care Provider/Practitioner: BEVERLYCARE

Information about “1114867710” NPI (BEVERLYCARE) exists in 1114867710 in HTML format HTML  |  1114867710 in plain Text format TXT  |  1114867710 in PDF (Portable Document Format) PDF  |  1114867710 in an XML format XML  formats.

NPI Number : 1114867710 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114867710",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BEVERLYCARE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "433 N 4TH ST STE 205A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MONTEBELLO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90640-4311",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "323-920-0505",
    "MailingAddressFaxNumber": "888-871-4071",
    "FirstLinePracticeLocationAddress": "520 W BEVERLY BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MONTEBELLO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90640-3622",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "323-920-0505",
    "PracticeLocationAddressFaxNumber": "888-871-4071",
    "EnumerationDate": "03/31/2026",
    "LastUpdateDate": "03/31/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HSIAO",
    "AuthorizedOfficialFirstName": "ANGEL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "323-920-0505",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QC1500X",
          "TaxonomyName": "Community Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QF0400X",
          "TaxonomyName": "Federally Qualified Health Center (FQHC)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.