{
"Npi": {
"NPI": "1326865668",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BE WELL BERLIN A PROFESSIONAL NURSING CORPORATION",
"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": "440 N BARRANCA AVE # 3666",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COVINA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91723-1722",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8671 WILSHIRE BLVD STE 701",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEVERLY HILLS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90211-2913",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-810-3666",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/25/2024",
"LastUpdateDate": "11/15/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BERLIN",
"AuthorizedOfficialFirstName": "ISAAC",
"AuthorizedOfficialMiddleName": "MENDYL",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "FNP-C",
"AuthorizedOfficialTelephoneNumber": "310-810-3666",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
]
}
}
}