Provider Demographics
NPI:1841662061
Name:B & G MEDICAL SERVICES
Entity type:Organization
Organization Name:B & G MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATIFICATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-214-8618
Mailing Address - Street 1:4000 BIRCH ST STE 112A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 BIRCH ST STE 112A
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2211
Practice Address - Country:US
Practice Address - Phone:949-214-8618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service