Provider Demographics
NPI:1609569029
Name:BEVERLY HILLS PHYSCIANS INSTITUTE A MEDICAL GROUP INC
Entity Type:Organization
Organization Name:BEVERLY HILLS PHYSCIANS INSTITUTE A MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-975-1881
Mailing Address - Street 1:115 JENSEN CT STE 200
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-7406
Mailing Address - Country:US
Mailing Address - Phone:805-777-8956
Mailing Address - Fax:866-586-9678
Practice Address - Street 1:115 JENSEN CT STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-7406
Practice Address - Country:US
Practice Address - Phone:805-777-8956
Practice Address - Fax:866-586-9678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty