| Bhcmg Executive Er | |
|
8530 Wilshire Blvd Suite 250 Beverly Hills CA 90211-3122 | |
| (310) 657-0366 | |
| (310) 657-0466 |
| Full Name | Bhcmg Executive Er |
|---|---|
| Speciality | Clinic/Center |
| Location | 8530 Wilshire Blvd, Beverly Hills, California |
| Authorized Official Name and Position | Daniel Jacobsen (PRESIDENT) |
| Authorized Official Contact | 3106570366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhcmg Executive Er 8530 Wilshire Blvd Suite 250 Beverly Hills CA 90211-3122 Ph: (310) 657-0366 | Bhcmg Executive Er 8530 Wilshire Blvd Suite 250 Beverly Hills CA 90211-3122 Ph: (310) 657-0366 |
| NPI Number | 1053642009 |
|---|---|
| Provider Enumeration Date | 01/14/2010 |
| Last Update Date | 01/14/2010 |
| Medicare PECOS PAC ID | 9638207905 |
|---|---|
| Medicare Enrollment ID | O20100506000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053642009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | A85541 (California) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | DC15646 (California) | Secondary |
| Provider Name | Daniel F Jacobsen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1629178199 PECOS PAC ID: 6204899966 Enrollment ID: I20050330000769 |
| Provider Name | Leif E Lunsford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740236967 PECOS PAC ID: 5890791842 Enrollment ID: I20061013000388 |
| Provider Name | Darren M Boyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992960462 PECOS PAC ID: 8224355086 Enrollment ID: I20150317000002 |
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