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BEVERLY MEDICAL GROUP
NPI 1326622143
Clinic/Center in Los Angeles, CA

Active since May 07, 2021
2105 BEVERLY BLVD STE 233B, LOS ANGELES, CA 90057(213) 674-7859(213) 277-1055 Get Directions Write a Review

NPPES record last updated: June 23, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 23, 2021, May 7, 2021 (2 updates tracked since 2021).

About Beverly Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEVERLY MEDICAL GROUP (NPI 1326622143) is a healthcare organization registered as a clinic/center in Los Angeles, California and active in the NPI registry since May 2021. The organization lists Nicholas N Dzebolo, Ceo, as its authorized official.

NPPES Registry Identity

NPI1326622143
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameBEVERLY MEDICAL GROUP
Location Address2105 BEVERLY BLVD STE 233BLos Angeles, CA 90057-2216
Mailing Address2105 Beverly Blvd Ste 233bLos Angeles, CA 90057-2216 · (213) 674-7859 · Fax (213) 674-7863
Phone(213) 674-7859
Fax(213) 277-1055
Organization SubpartNo
Authorized OfficialNicholas N DzeboloCeo · (132) 771-0302
Enumeration DateMay 7, 2021
Last NPPES UpdateJune 23, 20212 updates tracked since enumeration
NPPES CertifiedJune 23, 2021
✔ NPI 1326622143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
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).
2105 BEVERLY BLVD STE 233B, Los Angeles, CA 90057
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beverly Medical Group's NPI number?

The NPI number for Beverly Medical Group is 1326622143. It was assigned to this organization in the NPPES registry on May 7, 2021.

Where is Beverly Medical Group located?

Beverly Medical Group is located at 2105 Beverly Blvd Ste 233B, Los Angeles, CA 90057. The listed phone number is (213) 674-7859.

What is Beverly Medical Group's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Beverly Medical Group was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.