Provider Demographics
NPI:1740280445
Name:BEHAVIORAL HEALTH MEDICAL GROUP OF BEVERLY HILLS INC.
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH MEDICAL GROUP OF BEVERLY HILLS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-274-4372
Mailing Address - Street 1:9171 WILSHIRE BOULEVARD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5516
Mailing Address - Country:US
Mailing Address - Phone:310-274-4372
Mailing Address - Fax:310-274-5146
Practice Address - Street 1:9171 WILSHIRE BOULEVARD
Practice Address - Street 2:SUITE 310
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5516
Practice Address - Country:US
Practice Address - Phone:310-274-4372
Practice Address - Fax:310-274-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP246742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0082340Medicaid
CACI6502OtherRAILROAD MEDICARE
CA=========OtherTRICARE
CAGR0082340Medicaid