BEVERLY MEDICAL GROUP NICK NICHOLAS DZEBOLO
Clinic/Center

Address: 2105 Beverly Blvd Ste 233b, Los Angeles, CA 90057-2216

BEVERLY MEDICAL GROUP NICK NICHOLAS DZEBOLO (NPI# 1326622143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326622143
Entity Type Organization
Organization Name BEVERLY MEDICAL GROUP NICK NICHOLAS DZEBOLO
Practice Address 2105 Beverly Blvd Ste 233b
Los Angeles
CA 90057-2216
Practice Telephone 2136747859
Practice Fax Number 2136747863
Mailing Address 2105 Beverly Blvd Ste 233b
Los Angeles
CA 90057-2216
Mailing Telephone 2136747859
Mailing Fax Number 2136747863
Certification Date 2021-05-07
Enumeration Date 2021-05-07
Last Update Date 2021-05-07
Authorized Official Telephone 6262816442
Authorized Official Credential M.D
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Office Location

Street Address 2105 BEVERLY BLVD STE 233B
City LOS ANGELES
State CA
Zip Code 90057-2216

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225307382 Jay J. Chobdee, Dds A Professional Corporation Dentist 2105 Beverly Blvd, #101, Los Angeles, CA 90057-2216 2011-12-19
1023047669 George Umaguing Suyat Internal Medicine 2105 Beverly Blvd, Suite 131, Los Angeles, CA 90057-2216 2006-07-03
1457861429 Cristina Chiong-Antonio Physical Therapist 2105 Beverly Blvd, Los Angeles, CA 90057-2216 2017-10-04
1063886315 Beverly Multispecialty Clinic Inc Internal Medicine 2105 Beverly Blvd, Ste 111, Los Angeles, CA 90057-2216 2015-11-24
1164656187 Annabella B Chu Dmd Inc Dentist - General Practice 2105 Beverly Blvd, Ste. 215, Los Angeles, CA 90057-2216 2009-05-05
1922274257 Glory Cabanilla Tancinco,M.d. Inc. · Glory Cabanilla Tancinco,M.d.inc. Anesthesiology - Pediatric Anesthesiology 2105 Beverly Blvd, Suite #111, Los Angeles, CA 90057-2216 2008-05-06
1760522312 Annabella Chu King · Annabella B Chu Dentist - General Practice 2105 Beverly Blvd, Ste. 215, Los Angeles, CA 90057-2216 2007-02-06
1124351713 Orbit Care Inc Internal Medicine 2105 Beverly Blvd, Ste 231, Los Angeles, CA 90057-2216 2009-09-14
1245372408 Soheil Mehdizadeh Chiropractic Corp. · Soheil Mehdizadeh, D.c., Qme., Corp. Chiropractor 2105 Beverly Blvd, Suite# 207, Los Angeles, CA 90057-2216 2007-02-13
1346580826 Jessica Esther Aguiamos Social Worker - Clinical 2105 Beverly Blvd, Los Angeles, CA 90057-2216 2013-02-21
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Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1316486848 Razan Tarik Alzamzami Marriage & Family Therapist 1926 Beverly Blvd (baart), Los Angeles, CA 90057 2017-02-16
1033628607 Laura Anne Salm Case Manager/Care Coordinator Homeless Healthcare Los Angeles, 2330 Beverly Blvd, Los Angeles, CA 90057 2017-09-26
1851887012 Scott Moon Dentist 2426 W. 8th St. #209, Los Angeles, CA 90057 2018-07-10
1033699319 Stephanie A Pinilla Social Worker 520 S Lafayette Park Place, 3rd Floor, Los Angeles, CA 90057 2018-08-16
1356818850 Anshim Acupuncture Inc · Anshim Clinic Acupuncturist 4501 Alameda St., #107b #115, Los Angeles, CA 90057 2018-11-01
1306323506 Jessica Myung Jin Yun Student in an Organized Health Care Education/Training Program 520 S Lafayette Park Pl, Unit 300, Los Angeles, CA 90057 2018-07-20
1982150629 Jordan Rock Audiologist 2100 W. Third St., #111, Los Angeles, CA 90057 2016-09-01
1720596414 Hee Sun No Pharmacist 269 S Lafayette Park Pl, 210, Los Angeles, CA 90057 2018-01-16
1750832622 Suk Yin Lee Social Worker 2131 W. 3rd Street, Los Angeles, CA 90057 2016-10-17
1538634670 Karina Herrera · Karina Herrera Case Manager/Care Coordinator 679 S. Hampshire Ave, Los Angeles, CA 90057 2018-10-04
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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1225625270 Invu Med Spa Inc Clinic/Center 2875 W 7th St, Los Angeles, CA 90005 2020-12-23
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1790304186 Tatyana Rem Clinic/Center 1745 Silver Lake Bvld, Los Angeles, CA 90026-1221 2020-04-15
1255950424 What's In It, LLC. Clinic/Center 10323 Woodbine St Apt 105, Los Angeles, CA 90034-3749 2020-04-08
1487294187 Mcneill Psychology Inc. Clinic/Center 1910 Hillhurst Ave, Los Angeles, CA 90027-2712 2020-01-09
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Competitor

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City LOS ANGELES
Zip Code 90057

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.