Provider Demographics
NPI:1043060767
Name:BEACH CITIES HEALTH DISTRICT
Entity Type:Organization
Organization Name:BEACH CITIES HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-374-3426
Mailing Address - Street 1:1200 DEL AMO ST
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3050
Mailing Address - Country:US
Mailing Address - Phone:310-374-3426
Mailing Address - Fax:310-376-4738
Practice Address - Street 1:514 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3036
Practice Address - Country:US
Practice Address - Phone:310-374-3426
Practice Address - Fax:310-376-4738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health